Bruising
Contents

Side effects of permanent seed brachytherapy

Permanent seed brachytherapy can cause side effects. These side effects affect each person differently, and you might not get all of the side effecs lsited on this page. 

Bruising

At first, you notice bruising in the area between your testicles and back passage, which may spread to your inner thighs and penis. This should disappear in a week or two.

Urinary problems

Permanent seed brachytherapy can cause urinary problems. These problems may be worse in the first few weeks after treatment, especially in men with a large prostate. They usually start to improve after a few months. Most men will have recovered after a year. 

Bladder irritation

Permanent seed brachytherapy can irritate the bladder and urethra. This is called radiation cystitis. Symptoms include:

  • difficulty urinating

  • needing to urinate more often or urgently, especially at night

  • discomfort or a burning feeling when you urinate

  • blood-stained urine or rusty or brown-coloured semen for a few days or weeks.

Difficulty urinating

In some men, permanent seed brachytherapy can cause the prostate to swell, narrowing the urethra and making it difficult to urinate in the first few days or weeks after treatment. This is more likely if you have brachytherapy combined with external beam radiotherapy.

A few men may find they suddenly and painfully can’t urinate at all. This is called acute urine retention. If this happens, contact your doctor or nurse straight away, or go to your nearest accident and emergency (A&E) department as soon as possible. They may need to put in a catheter to drain the urine.

The treatment can also cause scarring in the urethra, making it narrower over time. This is called a stricture, and can also make it difficult to urinate. This is rare and may happen several months or years after treatment. If it happens, you might need an operation to widen your urethra or the opening of the bladder.

Leaking urine

Some men experience leaking (urinary incontinence) after permanent seed brachytherapy, but this is rare. It may be more likely if you’ve previously had a TURP.

What can help with urinary problems?

The following may help you manage any urinary problems.

  • Medicines called alpha-blockers.

  • Drinking liquid regularly (two litres or three to four pints a day).

  • Avoiding drinks that may irritate the bladder, such as alcohol, fizzy drinks, artificial sweeteners, and drinks with caffeine, such as tea and coffee.

  • Pelvic floor muscle exercises.

Read more about urinary problems after prostate cancer treatment.

Bowel problems

Permanent seed brachytherapy can irritate the lining of the bowel and back passage, which can cause bowel problems. But bowel problems after permanent seed brachytherapy tend to be mild and the risk is low.

You are more likely to have bowel problems if you’re also having external beam radiotherapy. You might have a rectal spacer, a gel placed between your prostate and back passage, to help protect your back passage from radiation.

What bowel problems might I have?

Bowel problems may include:

  • loose and watery bowel movements (diarrhoea)

  • passing more wind than usual

  • needing to empty your bowels more often

  • needing to empty your bowels urgently

  • feeling that you need to empty your bowels but not being able to go.

 A small number of men may have bleeding from the back passage. But this can also be a sign of other problems. Tell your nurse or GP about any bleeding. You may have tests to find out what’s causing it. Read more about bowel problems on our website.

Screening for bowel cancer

If you’re invited to take part in the NHS bowel screening programme soon after having permanent seed brachytherapy, the test may pick up some blood in your bowel movements. 

Your doctor, nurse or radiographer may suggestdelaying the test for a few months to help avoid incorrect results.

Some men notice blood in their bowel movements after treatment. This is usually nothing to worry about, but tell your doctor, nurse or radiographer if you notice any blood.

Sexual problems

Permanent seed brachytherapy can affect the blood vessels and nerves that control erections. This may cause problems getting or keeping an erection (erectile dysfunction).

For some men, erection problems may not happen straight away but can develop several months later. Men who do get erection problems usually experience them within the first three years after treatment.

The risk of long-term erection problems after brachytherapy varies from man to man. You may be more likely to have them if you had problems in the past, or if you’re also having hormone therapy or external beam radiotherapy.

There are many treatments for erection problems, including taking PDE5 inhibitors (phosphodiesterase type 5 inhibitors). Speak to your doctor about your treatment options.

Other sexual side effects you might experience include:

  • producing less or no semen.

  • a little blood in your semen for a few months. This is not usually a problem and should go away in a few weeks, but tell your doctor or nurse if there is a lot.

  • orgasms may feel different. A small number of men find they can no longer orgasm.

  • You may feel pain in your penis when you ejaculate, especially soon after the seeds have been inserted. Tell your doctor or nurse if this happens.

If you have anal sex or anal play

If you have anal sex and are usually the penetrative partner, erection problems may affect your sex life. But there are  ways to manage this, including treatments that may help keep your erection hard enough for penetrative sex.

Your doctor may suggest that you avoid receiving anal sex or anal play for the first six months after permanent seed brachytherapy. If you have bowel problems or a sensitive anus, you may also want to wait until these have improved. Ask your doctor about how long.

Find out more in our information for gay and bisexual men.

Having children

Permanent seed brachytherapy can affect fertility, meaning you may not be able to have children naturally.

It’s also possible that the radiation could change your sperm and this might affect any children you do conceive. The risk is very low, but you should use contraception for at least a year after treatment if there’s a chance you could get someone pregnant.

If you plan to have children in the future, you can store your sperm before treatment to use it later for fertility treatment. Sperm can usually be stored for up to 10 years, sometimes longer. Ask your doctor for more information.

Tiredness and fatigue

You may feel tired for the first few days after treatment as you recover from the anaesthetic. The effect of radiation on the body may make you feel tired for longer, especially if you’re also having external beam radiotherapy or hormone therapy.

If you get up a lot during the night to urinate, this can also make you feel tired during the day.

Fatigue is extreme tiredness that can affect your everyday life. It can affect your energy levels, motivation and emotions. Fatigue can continue after the treatment has finished and may last several months.

There are things you can do to help manage your fatigue, such as planning your day to make the most of when you have more energy. Our Specialist Nurses also offer support that can help you improve your fatigue over time.

Long-term side effects

Some men develop long-term or late side effects after radiotherapy treatment. This is called pelvic radiation disease and there is more information about this on the Pelvic Radiation Disease Association website.

References and reviewers

Updated: September 2026 | Due for Review: September 2029

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This publication was written and edited by our Health Information team.

It was reviewed by:

  • Peter Bownes, Consultant Clinical Scientist, Leeds Teaching Hospitals NHS Trust

  • Richard Gledhill, Prostate Cancer Nurse Specialist, University Hospitals Birmingham

  • Ann Henry, Clinical Oncologist, Leeds Teaching Hospitals NHS Trust

  • Stephen Langley, Clinical Urologist, Royal Surrey Cancer Centre & NHS Hospital

  • Our Specialist Nurses

  • Our volunteers.

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