About Your Prostate Ablation Procedure

This information will help you get ready for your prostate ablation procedure at Memorial Sloan Kettering (MSK). It will also help you understand what to expect after your procedure.

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About Your Prostate

Figure 1. Male reproductive system

Figure 1. Male reproductive system

  • Your prostate is a small, firm gland about the size of a walnut. It’s in front of your rectum, below your bladder (see Figure 1). Your prostate works with other glands in your body to make semen.
  • Your urethra is a tube that carries urine (pee) from your bladder, through your penis, and out of your body.
  • Your seminal vesicles are small glands near your prostate that make the fluid in semen.
  • Your perineum is the space between your scrotum and anus.
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About Your Prostate Ablation Procedure

Prostate ablation is a procedure used to treat prostate cancer. During a prostate ablation procedure, energy (such as heat, cold, lasers, or chemicals) is used to kill the cancer cells. The energy may also destroy some of the surrounding normal prostate tissue.

You’ll get anesthesia (medication to make you sleep during your procedure) before your procedure unless your healthcare provider tells you otherwise. Once you’re asleep, you’ll be positioned on your back with your legs supported and raised above your hips with your knees bent.

Your healthcare provider may place a cystoscope (small, flexible camera) through your urethra to your prostate and bladder after you’re asleep, before your ablation. This is to check for anything that might affect your procedure.

Prostate ablation can be done with a needle ablation or with high-frequency ultrasound energy. Your healthcare provider will talk with you about which type of ablation is best for you.

Needle ablation

If you’re having a needle ablation, a small ultrasound probe will be put into your rectum. The ultrasound probe uses sound waves to show your prostate on a video screen. Your healthcare provider will use these images as they guide small needles into your prostate. The needles will be held in place by a template, which is a small, square piece of plastic with many holes in it.

Once the needles are in place, your healthcare provider will use them to deliver the treatment to your prostate. The treatment will take 20 to 30 minutes.

After the treatment is finished, the needles and probe will be taken out and you’ll be taken to the recovery room.

Ablation through high-frequency ultrasound energy

If you’re having ablation through high-frequency ultrasound energy, a small ultrasound probe will be placed into your rectum so your healthcare provider can see your prostate.

After your treatment is completed, the probe will be taken out and you’ll be taken to the recovery room.

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Getting Ready for Your Procedure

You and your healthcare team will work together to get ready for your procedure. Help us keep you safe during your procedure by telling us if any of the following statements apply to you, even if you aren’t sure.

  • I take a blood thinner. Some examples are aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). There are others, so be sure your healthcare provider knows all the medications you’re taking.
  • I take prescription medications (medications prescribed by a healthcare provider), including patches and creams.
  • I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
  • I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I’ve had a problem with anesthesia (medication to make you sleep during surgery) in the past.
  • I’m allergic to certain medication(s) or materials, including latex.
  • I’m not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • I use recreational drugs.

About drinking alcohol

The amount of alcohol you drink can affect you during and after your procedure. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

  • If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these complications, we can prescribe medications to help keep them from happening.
  • If you drink alcohol regularly, you may be at risk for other complications during and after your procedure. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do before your procedure to keep from having problems:

  • Be honest with your healthcare providers about how much alcohol you drink.
  • Try to stop drinking alcohol once your procedure is planned. If you develop a headache, nausea (feeling like you’re going to throw up), increased anxiety, or can’t sleep after you stop drinking, tell your healthcare provider right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you can’t stop drinking.
  • Ask your healthcare provider questions about drinking and your procedure. As always, all of your medical information will be kept confidential.

About smoking

If you smoke, you can have breathing problems when you have a procedure. Stopping even for a few days before your procedure can help. If you smoke, your healthcare provider will refer you to our Tobacco Treatment Program. You can also reach the program by calling 212-610-0507.

 

About sleep apnea

Sleep apnea is a common breathing disorder that causes you to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes completely blocked during sleep. OSA can cause serious problems during and after your procedure.

Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing device (such as a CPAP device) for sleep apnea, bring it with you the day of your procedure.

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Within 30 Days of Your Procedure

Presurgical testing (PST)

Before your procedure, you’ll have an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your healthcare provider’s office.

You can eat and take your usual medications the day of your PST appointment.

During your appointment, you’ll meet with a nurse practitioner (NP) who works closely with anesthesiology staff (specialized healthcare providers who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You may have tests, such as an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

It’s very helpful to bring the following things to your PST appointment:

  • A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name(s) and telephone number(s) of your healthcare provider(s).

Identify your caregiver

Your caregiver plays an important role in your care. You and your caregiver will learn about your procedure from your healthcare provider. After your procedure, your caregiver should be with you when you’re given your discharge instructions so they’re able to help you care for yourself at home. Your caregiver will also need to take you home after you’re discharged from (leave) the hospital.

Complete a Health Care Proxy form

If you haven’t already completed a Health Care Proxy form, we recommend you complete one now. If you have completed one already, or if you have any other advance directives, bring them to your next appointment.

A health care proxy is a legal document that identifies the person who will speak for you if you can’t communicate for yourself. The person you identify is called your health care agent.

Talk with your healthcare provider if you’re interested in completing a health care proxy. You can also read the resources Advance Care Planning and How to Be a Health Care Agent for information about health care proxies, other advance directives, and being a health care agent.

Exercise

Try to do aerobic exercise (exercise that makes your heart beat faster) every day. Examples include walking at least 1 mile (1.6 kilometers), swimming, or biking. If it’s cold outside, use stairs in your home or go to a mall or shopping center. Exercising will help your body get into its best condition for your procedure and make your recovery faster and easier.

 
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7 Days Before Your Procedure

Follow your healthcare provider’s instructions for taking aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your procedure. Aspirin can cause bleeding.

Follow your healthcare provider’s instructions. Don’t stop taking aspirin unless they tell you to. For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your procedure. These things can cause bleeding. For more information, read Herbal Remedies and Cancer Treatment.

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2 Days Before Your Procedure

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

Stop taking NSAIDs, such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

Start taking tamsulosin (Flomax®)

Your healthcare provider will give you a prescription for tamsulosin to help you urinate (pee) after your procedure. Start taking the tamsulosin 2 days before your procedure or as directed by your healthcare provider.

 

Arrange for someone to take you home

You must have a responsible care partner take you home after your procedure. Make sure to plan this before the day of your procedure.

If you don’t have someone to take you home, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.

Agencies in New York                                         Agencies in New Jersey
Partners in Care: 888-735-8913                                         Caring People: 877-227-4649
Caring People: 877-227-4649                                          

 

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1 Day Before Your Procedure

Follow the diet your healthcare provider recommends

Depending on the type of ablation procedure you’re having, you may need to follow a light diet or a low residue diet. Your healthcare provider will check the box below next to the diet you should follow. Start following it the morning of the day before your procedure.

  • Light diet
    Follow a light diet, such as small sandwiches, eggs, toast, crackers, soup, or cereal. Limit the amount of dairy products and avoid friend foods and foods with a lot of seasoning.
  • Low-residue diet
    Follow a low residue diet. This diet limits high-fiber foods, such as whole grain breads and cereals, nuts, seeds, and raw or dried fruits and vegetables. You should also limit the amount of dairy products you have.

Start taking antibiotics, if needed

If your healthcare provider gives you a prescription for antibiotics, start taking them 1 day before your procedure.

 

Note the time of your procedure

A staff member from the Admitting Office will call you after 2:00 pm the day before your procedure. If your procedure is scheduled for a Monday, they’ll call you on the Friday before.

The staff member will tell you what time to arrive at the hospital for your procedure. They’ll also remind you where to go. If you don’t get a call by 7:00 pm, call 212-639-5014.

Sleep

Go to bed early and get a full night’s sleep.

Instructions for eating and drinking before your procedure
12 ounces of water
  • Do not eat anything after midnight the night before your procedure. This includes hard candy and gum.
  • Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see figure).
  • Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water.
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The Morning of Your Procedure

Take your medications

If your healthcare provider told you to take certain medications the morning of your procedure, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Give yourself a saline enema

Give yourself a saline enema (such as a Fleet® saline enema) the morning of your procedure. Follow the directions on the box. You can buy this at your local pharmacy.

Things to remember

  • Wear comfortable, loose-fitting pants with an elastic waistband.
  • Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your procedure can cause burns if it touches metal.
  • Leave valuable items (such as credit cards, jewelry, and your checkbook) at home.
  • Before you’re taken into the operating room, you’ll need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles.
  • If you wear contacts, wear your glasses instead. Wearing contact lenses during your procedure can damage your eyes.

What to bring

  • Your breathing device for sleep apnea (such as your CPAP device), if you have one.
  • Your Health Care Proxy form and other advance directives, if you have completed them.
  • A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
  • This guide. Your healthcare team will use this guide to teach you how to care for yourself after your procedure.

Once you’re in the hospital

You’ll be asked to say and spell your name and birth date many times. This is for your safety. People with the same or a similar name may be having a procedure on the same day.

Get dressed for your procedure

When it’s time to change for your procedure, you’ll get a hospital gown, robe, and nonskid socks to wear.

Meet with a nurse

You’ll meet with a nurse before your procedure. Tell them the dose of any medications you took after midnight (including prescription and over-the-counter medications, patches, and creams) and the time you took them.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse doesn’t place the IV, your anesthesiologist will do it in the operating room.

Meet with an anesthesiologist

You’ll also meet with an anesthesiologist before your procedure. They will:

  • Review your medical history with you.
  • Ask you if you’ve had any problems with anesthesia in the past, including nausea or pain.
  • Talk with you about your comfort and safety during your procedure.
  • Talk with you about the kind of anesthesia you’ll get.
  • Answer your questions about your anesthesia.

Get ready for your procedure

Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your procedure to start. When it’s time for your procedure, your visitor(s) will be taken to the waiting area. Your visitors should read Information for Family and Friends for the Day of Surgery.

You’ll either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line and you’ll fall asleep. You’ll also get fluids through your IV line during and after your procedure.

After you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. You’ll also have a urinary (Foley) catheter placed to drain urine from your bladder.

Your breathing tube is usually taken out while you’re still in the operating room.

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After Your Procedure

A nurse will be monitoring your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth.

Your visitors can see you once you’re awake and feel ready for them. This is usually after about 30 minutes to 1 hour. A member of the nursing staff will explain the guidelines to them.

Managing your pain

For the first 6 to 8 hours after your procedure, apply ice packs to your perineum for 20 minutes on and then 20 minutes off. This helps reduce discomfort, swelling, and bruising. Don’t put the ice packs right on your skin.

You’ll probably have some pain for about 1 to 2 days after your procedure. You can take an over-the-counter pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil®) to help with any discomfort.

Tubes and drains

You’ll have a urinary catheter in your bladder. This is so your care team can keep track of how much urine you’re making. You might be discharged with the catheter still in place. If you are, your healthcare provider will tell you when to take it out. They’ll give you written instructions. You can also watch the video How to Remove your Urinary (Foley) Catheter.

Leaving the hospital

You’ll go home the same day as your procedure. It’s important to have a responsible care partner to take you home.

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After You Leave the Hospital

  • Follow your healthcare provider’s instructions for taking your antibiotics and tamsulosin (Flomax).
  • Don’t shower for the first 24 hours after your procedure. After 24 hours, you can go back to showering as usual. Don’t take a tub bath or submerge your lower body in water for 2 weeks after your procedure.
  • Don’t lift anything heavier than 20 pounds (9 kilograms) for at least 48 hours (2 days) after your procedure. Your healthcare provider will tell you if you need to wait longer than 48 hours.

Changes in urination

  • Your urine may be pink tinted or have small amounts of blood in it for a few days after your procedure. If you have any heavy bleeding or blood clots in your catheter, call your healthcare provider.
  • You may have a burning feeling when you urinate for 1 to 2 weeks after your procedure. Your healthcare provider will give you a prescription for medication to help with this, if needed.
  • Your urine may flow more slowly than usual for about 2 to 3 weeks after your procedure.
  • You may urinate more often than usual for up to 6 weeks after your procedure.

Swelling, bruising, or bleeding

  • Your scrotum and the skin beneath it may have bruising and swelling after your procedure. This usually goes away within a few days, but it sometimes lasts for 2 to 3 weeks. To help with bruising and swelling, hold an ice pack on your perineum for 20 minutes, then take it off for 20 minutes. Repeat as needed. Don’t put the ice pack right on your skin.
  • If you had a needle ablation, you may have light bleeding from your puncture sites for 1 to 2 days after your procedure. If you do, apply steady pressure with a clean, dry washcloth or gauze to the area for 5 minutes. If the bleeding becomes heavy or doesn’t stop, call your healthcare provider.
  • You may have tenderness in your perineum. This may continue for several days after your procedure. If the area becomes very red, tender, or swollen, call your healthcare provider.
  • You may have a pink-tinted fluid coming from your urethra for a few days or weeks after your procedure. This is temporary. It’s caused by swelling in your prostate from the treatment.

Changes in sexual function

  • Your semen may contain a small amount of blood for several weeks.
  • You may ejaculate less semen than you did before your procedure. This is permanent.
  • You may have changes in erectile function (your ability to get an erection). Your healthcare provider will talk with you about this.
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When to Call Your Healthcare Provider

Call your healthcare provider if you have:

  • New or worsening shortness of breath
  • A fever of 101 °F (38.3 °C) or higher
  • Chills
  • Heavy bleeding or blood clots in your catheter
  • Pain or tenderness in your testicles
  • Pain that doesn’t get better with your medications
  • Any new symptom or physical change
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Support Services

MSK Support Services

The following are MSK support services that you may find helpful.

Admitting Office
212-639-7606
Call if you have questions about your hospital admission, including requesting a private room.

Anesthesia
212-639-6840
Call if you have questions about anesthesia.

Blood Donor Room
212-639-7643
Call for more information if you’re interested in donating blood or platelets.

Bobst International Center
888-675-7722
MSK welcomes patients from around the world. If you’re an international patient, call for help arranging your care.

Chaplaincy Service
212-639-5982
At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.

Counseling Center
646-888-0200
Many people find that counseling helps them. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.

Food Pantry Program
646-888-8055
The food pantry program provides food to people in need during their cancer treatment. For more information, talk with your healthcare provider or call the number above.

Integrative Medicine Service
646-888-0800
Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or speak with the library reference staff to find more information about your specific cancer type. You can also visit LibGuides on MSK’s library website at libguides.mskcc.org.

Patient and Caregiver Education
www.mskcc.org/pe
Visit the Patient and Caregiver Education website to search our virtual library. There, you can find written educational resources, videos, and online programs.

Patient and Caregiver Peer Support Program
212-639-5007
You may find it comforting to speak with someone who has been through a treatment similar to yours. You can talk with a former MSK patient or caregiver through our Patient and Caregiver Peer Support Program. These conversations are confidential. They may take place in person or over the phone.

Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
212-639-7202
Call if you have questions about the Health Care Proxy form or if you have concerns about your care.

Perioperative Nurse Liaison
212-639-5935
Call if you have questions about MSK releasing any information while you’re having surgery.

Private Duty Nursing Office
212-639-6892
You may request private nurses or companions. Call for more information.

Resources for Life After Cancer (RLAC) Program
646-888-8106
At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.

Sexual Health Programs
Cancer and cancer treatments can have an impact on your sexual health. MSK’s Sexual Health Programs can help you take action and address sexual health issues before, during, or after your treatment.

  • Our Female Sexual Medicine and Women’s Health Program helps women who are dealing with cancer-related sexual health challenges, including premature menopause and fertility issues. For more information, or to make an appointment, call 646-888-5076.
  • Our Male Sexual and Reproductive Medicine Program helps men who are dealing with cancer-related sexual health challenges, including erectile dysfunction. For more information, or to make an appointment, call 646-888-6024.

Social Work
212-639-7020
Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help refer you to community agencies and programs, as well as financial resources if you’re eligible.

Tobacco Treatment Program
212-610-0507
If you want to quit smoking, MSK has specialists who can help. Call for more information.

Virtual Programs
www.mskcc.org/vp
MSK’s Virtual Programs offer online education and support for patients and caregivers, even when you can’t come to MSK in person. Through live, interactive sessions, you can learn about your diagnosis, what to expect during treatment, and how to prepare for the various stages of your cancer care. Sessions are confidential, free, and led by expert clinical staff. If you’re interested in joining a Virtual Program, visit our website at www.mskcc.org/vp for more information.

For more online information, visit the Cancer Types section of www.mskcc.org.

External support services

The following are services outside of MSK that you may find helpful.

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

The American Urologic Association Foundation
866-746-4282
www.urologyhealth.org

US TOO
800-808-7866
www.ustoo.org
Provides prostate cancer education and support programs and has a monthly newsletter called Hotsheet. Meetings are open to patients, spouses, significant others, interested medical personnel.

National Association for Continence
www.nafc.org

National Cancer Institute
www.cancer.gov

Prostate Cancer Foundation
www.pcf.org

Prostate Cancer Treatment Guidelines for Patients
www.nccn.org (also available in Spanish)

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