17 Francisco O. Durazo-Ruiz Rocío Roldan-Testillano Lara Rodriguez-Sanchez M. Pilar Laguna Liam N. Mendez-Bisgaard Adel Arezki Hussein Elkhatib Alejandro Hevia-Feliu Kai Zhang Jonathan Fainberg Nathan Perlis Jean de la Rosette Bernardino Minana-Lopez Theo M. de Reijke Maurice Anidjar Mark Emberton Phillip D. Stricker Rafael Sanchez-Salas ablation techniques electroporation prostatic neoplasms quality of life treatment outcome Scopus Web of Science 2025 2026-05-10 10.1016/j.prnil.2025.11.001 PROSTATE INTERNATIONAL The treatment of prostate cancer (PCa) requires approaches that eliminate malignant tissue while preserving essential urinary and sexual functions. Irreversible electroporation (IRE) represents a targeted ablative strategy that disrupts cellular membrane integrity through precise electrical pulses, demonstrating the capacity to ablate cancerous foci while sparing adjacent neurovascular bundles and sphincter mechanisms. This structured review examines the mechanistic foundations of IRE technology, evaluates current clinical evidence regarding safety and efficacy, and explores promising applications that may redefine precision urologic care. Existing clinical studies demonstrate encouraging oncological control rates with superior preservation of continence and erectile function compared to whole-gland treatments, though patient selection criteria and long-term durability remain areas requiring further investigation. Emerging applications include salvage therapy following radiation failure, integration with advanced multiparametric imaging for precision targeting, and combination strategies with systemic therapies. The regulatory approval status and economic implications of IRE implementation vary significantly across healthcare systems, creating disparities in patient access and adoption of this technology that must be addressed to ensure equitable availability of focal ablation options. As the technology matures, establishing standardized treatment protocols, refining patient selection algorithms, and conducting robust comparative effectiveness studies will be essential to define the optimal role of IRE within prostate cancer management. https://repo.bashgmu.ru/publication/5271 https://repo.bashgmu.ru/files/5461