Your local guy may be top notch BUT go to the big shop. You are looking for a whole TEAM to get you through it. I traveled 3.5 hours for my HDR brachytherapy at Mayo Rochester (two of them a week apart). I also went there for an ablation. All of those sad stories and downsides you read and hear about happen at local clinics. In both of my procedures I had zero pain and zero bad results. Admittedly, Mayo Rochester is the #1 hospital in the U.S. (overall) and the entire staff is amazing, literally, from the janitor in the lobby to the nurses and doctors, but any large hospital that is known for your procedure will have the entire staff working to care for you. In the case or Rochester, the whole city cares for you. Go to a hotel or a restaurant and everyone knows that one in the party is there for treatment. Kindness and caring abound. The locals know they ultimately work for what they refer to as "Mother Mayo". My advice, go big. You've decided on surgery. I appreciate the joking choice between Erect or erect but, for me, the downsides of a life with ED, incontinence, etc. was an easy choice for HDR.