Given that IRE is a focal ablative technique used to treat solid-organ tumors, the technical aspects of producing this form of ablation are cru­cial to oncologic success. Understanding the mechanism of IRE-based tissue ablation requires applying principles of delivering electrical energy uniformly and effectively to the targeted tissue. Importantly, IRE not only works to permanently damage cell membranes within the tissue, but due to its nonthermal and somewhat selective effects, preservation of extracellular macromolecules, connective tissue architecture, and larger blood vessels can maintain the structure of organ colla­gen scaffolds, vascularity, and peptides. These features have supported the considered safety for the use of IRE near sensitive anatomic sites such as the urethra, rectum, nerves, large blood vessels, and ducts of vital organs, similar to its common applications during pancreatic or liver ablations. This has been reported in animal models where vital structures have been preserved after IRE: solitary blood vessels remained unchanged 24 h post-ablation, and while perivascular brosis sand changes were noted, the vessels remained intact up to 35 days posttreatment [12]. These factors and the ability of IRE to spare critical structures are among the reasons IRE is used to treat some complex liver and pancreatic masses.

the gland, however focal, a minimum of three electrodes are utilized, and most experienced sur­geons utilize 4 or more. Electrode placement should be between 8 and 24 mm of distance between each probe of one and other. However, it is likely that the “sweet spot” for treatment plan­ning should utilize 10–20 mm to account for placement errors, and avoidance of unwanted thermal effects is closer to 10–20mm in distance. Probe congurations may vary to dene an appropriate ablation zone to encapsulate the tumor cells within the prostate. While triangular congurations are common with three probes, as the number of probes increases, the possibilities for expanding the ablation zone also increase.