DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Adenocarcinoma of the prostate.
POSTOPERATIVE DIAGNOSIS: Adenocarcinoma of the prostate.
PROCEDURE PERFORMED: Prostate brachytherapy.
SURGEON: John Doe, MD
ANESTHESIA: General anesthesia via LMA.
COMPLICATIONS: None.
DRAINS: One 18-French Foley catheter per urethra.
INDICATIONS FOR PROCEDURE: This patient has a new diagnosis of adenocarcinoma of the prostate diagnosed due to a very slowly rising PSA. His current PSA level is only 2.0, but prostate ultrasound biopsies were performed showing adenocarcinoma of the prostate at the left base of the prostate, and two biopsies were positive out of eight with a Gleason score of 6. Treatment options have been discussed, and he wishes to proceed with prostate brachytherapy. Informed consent has been obtained.
DESCRIPTION OF PROCEDURE: The patient was placed on the operating table in the supine position. General anesthesia was administered via LMA. He was then placed in the dorsal lithotomy position and sterilely prepped and draped in the usual fashion. The prostate ultrasound was inserted. The prostate was visualized using the preplanned study as a guide. Prostate brachytherapy was performed. The patient tolerated the procedure well and had no immediate intraoperative or postoperative complications.
We implanted a total of 54 iodine-125 radioactive seeds through 12 needles with each seed containing 0.373 millicurie per seed. During the procedure, the patient received 4 mg of Decadron IV and 400 mg of Cipro IV. Subsequent fluoroscopy showed good distribution of the seeds throughout the prostate. The patient will have a CAT scan of the pelvis and simulation for his seed localization. Total target dose is 14,500 cGy.
The patient will be discharged with prescriptions for Cardura 1 mg a day for a month with two refills and Tylenol No. 3 one t.i.d. p.r.n. for pain, a total of 20, Pyridium Plus one b.i.d. for 10 days, Cipro 500 mg b.i.d. for five days and prednisone 10 mg t.i.d. for a week.
Discharge instructions were explained to the patient and his wife. He will return to see Dr. Jane Doe in two weeks and Dr. John Doe in four weeks for a followup.
