Pulsed Electric Field (PEF) Ablation for Prostate Cancer
Also known in research as irreversible electroporation, PEF is a non‑thermal, focal therapy that uses a single probe placed transperineally—the same way we perform biopsies—to destroy targeted cancer while preserving normal tissue.
Educational content only; not a substitute for medical advice.
Why PEF Ablation at Advanced Urology?
KOELIS Trinity Navigation
Our KOELIS Trinity system combines your MRI with real‑time ultrasound to build a 3D map of the prostate. This GPS‑like guidance lets us plan and deliver energy to the tumor with high accuracy.
Single‑Probe, Transperineal
PEF uses a single probe inserted through the skin (transperineal), just like our biopsies. This route improves access to hard‑to‑reach areas and helps lower infection risk.
Focal, Non‑Thermal Energy
Instead of heating or freezing, PEF creates microscopic pores in cancer cell membranes, leading to natural cell death while helping spare nearby structures like the urethral sphincter and neurovascular bundles.
How PEF Works
Pulsed Electric Field ablation delivers very short, high‑voltage pulses through the probe tip into a precisely defined zone. Cancer cells are more vulnerable to this effect than healthy tissue. Because the energy is non‑thermal, surrounding structures are less likely to be damaged compared with heat‑based treatments.
- Planning: We contour the target on your MRI and fuse it with live ultrasound using KOELIS Trinity.
- Placement: A single probe is guided to the lesion under ultrasound, transperineally.
- Delivery: Pulses are applied for seconds to minutes to treat the planned zone.
- Assessment: Real‑time imaging confirms coverage; additional pulses can be delivered if needed.
Who Is a Candidate?
Often a Fit
- Localized or focal prostate cancer visible on MRI
- Desire to preserve urinary and sexual function
- Prior treatments that allow focal therapy (case‑by‑case)
May Not Be Ideal
- Extensive, multi‑focal high‑risk disease requiring whole‑gland therapy
- Contraindications to anesthesia or transperineal access
- Inability to undergo MRI or ultrasound guidance
Final candidacy is determined after reviewing your PSA, MRI, biopsy, and overall health.
How to Prepare
- Medications: We’ll give specific guidance for blood thinners and other medicines.
- Imaging: Bring or upload your most recent MRI and biopsy results.
- Day‑of: Simple anesthesia and arrival instructions will be provided ahead of time.
What to Expect on Procedure Day
Comfort in the ASC
PEF ablation is performed in our Ambulatory Surgery Center under anesthesia. Most cases are completed in about 30–60 minutes, and you go home the same day.
- Transperineal skin entry (like a biopsy)
- Single, targeted probe placement
- Typically mild soreness after, often managed with acetaminophen
Advanced Targeting
With KOELIS Trinity 3D MRI reconstructions, we align the treatment zone to your tumor in real time, helping ensure precise coverage and sparing of surrounding tissue.
Effectiveness, Safety & Follow‑Up
Published studies of PEF (also called irreversible electroporation) in carefully selected patients report encouraging cancer control with low rates of incontinence and preservation of erectile function for many men. Results vary by tumor location, size, and grade.
Follow‑Up Plan
- Regular PSA checks
- Follow‑up MRI and targeted biopsies as advised
- Review of urinary and sexual function at each visit
- Retreatment or additional therapy remains possible if needed
Risks & Considerations
- Temporary urinary symptoms (urgency, frequency), mild bleeding
- Urinary retention or infection (uncommon)
- Changes in erectile function (often less than with whole‑gland treatments)
- Need for additional treatment if residual cancer is found
Your care team will discuss expected outcomes and tailor follow‑up to your specific situation.
FAQs
How is this different from HIFU or cryotherapy?
PEF is non‑thermal. It does not heat or freeze the prostate. That helps protect structures responsible for continence and erections while still treating the tumor.
Can I still have other treatments later?
Yes. One advantage of focal PEF is that it does not burn bridges—you can still be a candidate for surgery, radiation, or repeat focal therapy if needed.
Will I need a catheter?
Some men may need a short catheter period after treatment depending on the location treated and swelling. Your surgeon will advise based on your plan.
Am I a candidate if I’ve had prior treatment?
Possibly. Suitability is individualized and depends on imaging, biopsy results, and prior therapies. We’ll review your records to provide a clear recommendation.
Ready to Explore a Precise, Organ‑Sparing Option?
Our single‑probe, transperineal PEF workflow with KOELIS Trinity guidance offers a modern focal approach to prostate cancer—designed to target the tumor and help protect what matters most.
Your plan is personalized to your PSA, imaging, biopsy, and health goals.