Irreversible Electroporation (IRE)

When prostate cancer is found early and can be mapped clearly, less treatment may mean more life preserved.

IRE works by sending short, controlled electrical pulses into the tumor. These pulses break down cancer cells without using heat, which helps protect nearby areas important for urinary control and sexual function. Most men go home the same day or the next morning and return to regular activities quickly.

1. Map the tumor: An MRI and ultrasound are used together to pinpoint the tumor.
2. Plan the treatment. Under anesthesia, we place thin electrodes through the skin between the scrotum and anus (the transperineal route) with real-time ultrasound guidance.
3. Deliver pulses. Brief electrical pulses open tiny pores in cancer cells, leading to cell death.
4. Verify and recover. The electrodes are removed, and most patients go home after a short recovery.

IRE may be an option if you have:

• A small, well-defined prostate tumor seen clearly on MRI
• Anatomy that allows safe focal therapy (based on MRI/ultrasound fusion planning)
• Patients who value organ-sparing options and understand that long-term data are still maturing
• Patients who can commit to close follow-up (prostate-specific antigen (PSA) testing, MRI, targeted biopsy when needed)

Some situations require a different approach (e.g., very large or multifocal tumors, high grade and/or locally advanced disease). At the University of Cincinnati Cancer Center’s Genitourinary Cancer Center, decisions are made together with urology, radiation oncology, medical oncology, radiology, and pathology at the table.

Potential benefits

• Targets only the known tumor (focal therapy)
• Aims to preserve urinary and sexual function
• Often outpatient or short hospital stay
• No use of thermal energy (unlike cryotherapy or high frequency focal ultrasound)        

Possible risks/side effects

• Temporary urinary symptoms, bleeding, or discomfort
• Urinary retention or infection (uncommon)
• Need for additional treatment later if new or persistent cancer appears

Current guidelines emphasize shared decision-making and careful counseling for focal therapy because evidence is evolving. 

• Before: You’ll have testing such as PSA, prostate MRI, and sometimes a biopsy.
• During: You’ll receive anesthesia. Most procedures take a few hours including prep and recovery.
• After: You may have mild soreness for a few days. Your care team will create a personalized follow-up plan.

• Expert team approach: Urology, radiology, oncology, and other specialists meet weekly to design your best treatment plan.
• Advanced imaging and focal therapy leadership: We are leaders in MRI/ultrasound fusion technology, which helps us precisely target tumors.
• Safety first: We use transperineal biopsy (through the skin, not rectum), which virtually annihilates infection risk.
• Pioneering expertise: Our radiologists helped create global standards for prostate MRI, including the PIRADS score, utilized worldwide to assess the need for a prostate biopsy.
• Innovative options & trials: Access to focal therapy, cellular therapy trials, gene therapy trials, proton therapy, and complex robotic surgery—all coordinated by a team focused on preserving quality of life.
• Complex robotic surgery: We are the only center in the region with the latest Da Vinci 5 robot, performing complex GU procedures led by fellowship-trained surgeons and pioneers in robotic prostatectomy.

For more information on irreversible electroporation (IRE) treatment or other treatment options for prostate cancer, contact the Genitourinary Cancer Center at the University of Cincinnati Cancer Center by calling 513-585-8222. Our team will guide you through every step, with your health and quality of life as our top priorities.