Equipment should be kept to a minimum. It must be checked to ensure that it is in working order, as maintenance staff will only be allowed into the room in exceptional circumstances.

Bedlinen and disposable items (e.g. gloves, aprons, catheter packs, sanitary towels) should be kept in a utility room or anteroom along with the patient's treatment chart and a radiation monitor.

The patient is usually admitted 12–48 hours before the procedure so that any pre‐anaesthetic investigations may be performed. Full bowel preparation with a low‐residue diet will reduce the chance of the patient having a bowel action while the sources are in place to help reduce the risk of sources being dislodged. If patients present with pre‐existing diarrhoea caused by previous radiotherapy on admission, regular antidiarrhoea medication should be prescribed and administered before and during the application of the sources. A full explanation should be given about the method and mode of treatment, possible side‐effects, radiation protection issues and obtaining informed consent. The patient should be encouraged to have a bath before any pre‐medication is administered.

LDR brachytherapy often follows 5 weeks of external beam radiotherapy (EBRT) to the pelvis (Petereit et al. [56]). Patients may embark on treatment already experiencing many symptoms, which are likely to include radiation‐induced enteritis, nausea, fatigue, pain and skin reactions. Management of these symptoms is essential to ensure the safe and effective use of LDR brachytherapy.

Prior to the procedure, patients should also be prepared for the number of applicators to be inserted, dependent on previous treatment. A urinary catheter will be inserted because of the restriction around movement during the treatment. Small but significant aspects to highlight to the patient at this pre‐assessment meeting include the noises made by the Selectron system, especially when sources are being transferred in and out of the applicators, that connection to the Selectron unit is with flexible plastic tubes, and informing all patients that this treatment will only enable them to lie in a semi‐recumbent position.

A maximum of two pillows can be used to support the head whilst maintaining the pelvis in roughly the same position, ensuring no significant movement of the applicators. Where practicable, the patient should be closely monitored during treatment using closed‐circuit television camera, telephone and/or intercom access for the patient as well as a nurse call system; all provide further reassurance for patients undergoing this treatment.