ABSTRACT
Hematomas are not uncommon sequelae of skin needle puncture sites. Not infrequently, hematomas are noted at intravenous sites or just after blood specimen draws. The prostate is surrounded by venous plexi and the perineum has a rich blood supply. These anatomic areas are necessarily violated for the purpose of prostate brachytherapy. Unfortunately to date, techniques of prostate brachytherapy have not evolved to avoid this side effect and most likely never will. Patients with perineal hematoma frequently complain of pain while sitting on hard surfaces. Bruising and discoloration may accompany a perineal hematoma, particularly on the perineum, scrotum, and medial aspects of the thighs. While bruising may take many weeks to resolve, a true perineal hematoma can take many months to resolve. Therefore, developing a perineal hematoma should be regarded as a real possibility when counseling patients prior to the actual procedure.
