This effect can either be reversible or irreversible. Reversible electroporation has been employed in electrochemotherapy to facilitate the uptake of chemotherapeutic agents into cells. The temporary damage to the cellular membrane allows the chemotherapeutic agent to enter the cell followed by recovery of the membrane.4 5 Damage becomes permanent above a certain selleck catalog threshold

of electrical pulse length and kV/cm, which causes cell death due to the inability of the cell to maintain homoeostasis. Initially, the manifestation of this irreversible component during electroporation was considered an unwanted treatment side effect.6–8 In recent years, interest in IRE as a tumour ablation modality by inducing irreversible cell damage has risen. IRE has shown to be able to effectively ablate tumour cells in vitro in animal experiments and recently in several human safety

and efficacy studies for liver, pancreas, pelvis, kidney and lung tumours.9–11 The two main factors have driven research in IRE as a treatment modality. First, studies in animals and humans have shown that connective tissue structure could be preserved with minor damage to associated blood vessels, neural tissue or other vital structures. Second, IRE lesions show a sharp demarcation between ablated and non-ablated tissue whereas lesions from thermal ablation techniques show a transitional zone containing partially damaged tissue between ablated and healthy tissue, because of partial conduction of heat or cold to the surrounding tissue. The patients will be assigned into two groups. The first group receives a focal ablation of the prostate (one lobe using 2–3 IRE needles); the second group will have an extended ablation (one or both lobes using >3 IRE needles). This allows us to assess the end points of the study in different template scenarios. The first primary objective is to determine if the IRE ablation procedure is safe as measured by the total

number of (1) device related and (2) periprocedural and postprocedural adverse events as measured using the NCI Common Terminology Criteria for Adverse Events (CTCAE). The second primary objective is to determine if complete ablation of the specified targeted Brefeldin_A ablation zone is achieved as measured by histopathology assessment. The first secondary objective is to determine if procedural side effects associated with current treatments for prostate cancer are avoided as measured by the following validated questionnaires: the five-item version of the international index of erectile function (IIEF-5), international prostate symptom score (IPSS) and if required, time of indwelling catheter. The second secondary objective is to determine quality of life (QoL) and comfort measured by expanded prostate cancer index composite (EPIC) and IPSS QoL score (IPSS-QoL), postprocedural pain management and pain scores using the visual analogue scale (VAS) and length of hospital stay.