High dose rate (HDR) brachytherapy has been refined and become more common since the mid-1990s. It is often administered in combination with external beam treatment as a “boost” to increase the total radiation dose and is used in men who have more advanced disease. It involves a short stay in hospital. Treatment is administered through needles placed into the prostate during a brief operation. It is typically given in the form of three or four “fractions” administered at least six hours apart, over two or three days. The needles are then removed from the prostate and the patient usually recovers quickly and is able to return home. Discomfort is a major side effect of HDR brachytherapy, as patients must lie flat on their backs for two days. Many men also find the catheter bothersome. In the long term, this technique does not seem to cause bowel problems, however it is often administered in conjunction with external beam radiotherapy that is associated with such difficulties. Impotence is more likely to affect patients after HDR brachytherapy than low dose rate (LDR) brachytherapy.