I had brachy 2 1/2 weeks ago and I would recommend it as mild and tolerable side effects.
Ultimately, its will be a decison that you have to make. I stayed away from surgery due to concerns about long-term major side-effects, particularly incontinence and ED, and an admittedly personal and probably unfounded fear that some cancer cells might not be removed. (It was mainly the side effects.) I was also not thrilled about a catheter, even for a few days.
So I did 15 months of active surveillance after diagnosis. I didn't think I'd avoid treatment, I just wanted to the the science advance as far as possible so maybe I could take advantage of new and better treatments. PSA's were very good (below 4) but then two consecutive above 5 and 2nd bisposy showed slow spread of low density Gleason 6. No sense waiting and I had decided brachy was going to be the treatment for me.
I was home the evening of the procedure and after 2 doses of pain meds, I didn't need them any more. I resumed unrinary function before I left the hospital. It hurt, but my suggestion is that you pee as soon as you are able, because it gets easier the more you go and the sooner you start to flow, the less the chance of a blockage. (Not to be too graphic, but my first pee after the procedure produced a small clump of bloody goo that I have to think was good to eliminate it before it had a chance to set and become and obstruction. Drink lots of water, too.
I have had the sense of blockage in bowel and urinary functions. Things take longer, but not really a problem. I take a stool softener just to make things easier and I have not needed Flomax, though most guys do.
As for irradiation of surrounding organs - it happens, that's why you have urinary and bowel irritation, but my belief was that external beam radiation has to go through all those organs to get to the prostate and then penetrate all the way through it. I liked the idea of focusing the radiation within the prostate and it made sense to me that surrounding tissue would get irradiated, but to a lesser degree than external radiation. I was told secondary cancers are not a concern with either treatment.
As to how I chose my radiation oncologist: I trusted my Uro who has been working with him for many years. I liked him when I met him and I really have a high opinion of the hospital where they perform the procedure. I did not shop around. It all felt right and I went with the flow. I feel very good about it.
Good luck. It's your call and you have the good fortune of several really efefctive options, with more on the way. Do your homework and make the decisions that you feel are right for you.
And it's OK to pray.....