NanoKnife Focal Therapy
A revolutionary prostate cancer treatment
Once prostate cancer has been diagnosed, patients are often presented with two choices: surgically remove the prostate or treat it with radiation. These traditional whole-gland treatments remain standard for many practitioners worldwide, but they are also associated with well-documented and lasting side effects.
At Vitus Private Clinic, we helped pioneer the clinical application of Irreversible Electroporation (IRE) using NanoKnife therapy for prostate cancer. This non-thermal focal therapy uses thin needle electrodes to target only the tumour while preserving surrounding nerves, vessels, and healthy tissue.
It is a minimally invasive treatment designed to eliminate cancer cells while maintaining continence, potency, and overall quality of life for prostate cancer patients.
Get Informed
It could change your life.
When choosing a prostate cancer treatment, our most important message is simple: don’t be rushed or pressured. Prostate cancer often progresses slowly, giving you time to understand your options and make a well-informed decision.
Take the time to learn about each therapy, as some treatment paths limit what can be done later. One advantage of NanoKnife IRE is that it keeps future options open, and surgery or radiation therapy can still be performed if ever needed.
Get in touch with us. It could change your life.
Call us now on +49 (0)177 23 82 863 or get in touch using the contact form
Irreversible Electroporation (IRE) with NanoKnife
What Is IRE?
Irreversible Electroporation (IRE), performed using NanoKnife technology, is a non-thermal tissue ablation method that destroys cancer cells while preserving surrounding nerves, vessels, and connective tissue.
Because IRE does not use heat or freezing, it avoids thermal damage to nerves and surrounding structures. The procedure is performed through thin needle electrodes rather than surgical incisions, which means minimal scarring and very little treatment-related pain.
As a result, IRE is a truly minimally invasive option that helps patients maintain continence and significantly reduces the risk of impotence compared to traditional whole prostate gland treatments.
At Vitus Private Clinic, we helped pioneer the clinical use of NanoKnife IRE through early collaboration with Prof. Boris Rubinsky, one of the technology’s inventors. With more than 2,000 prostate treatments performed, we have refined techniques that extend eligibility beyond most clinics, allowing us to treat localized prostate cancer, intermediate risk prostate cancer, and select advanced cases with precision.
Why Choose Vitus
- More than 2,000 IRE prostate treatments performed
- Direct collaboration with the inventor of medical IRE
- Advanced manual electrode techniques refined over more than a decade
Videos About Our NanoKnife (IRE) Treatment for Prostate Cancer
How IRE Works
During a NanoKnife IRE procedure, thin needle electrodes are placed into the treatment zone of the prostate and short, high-voltage pulses are applied between them. These pulses trigger Irreversible Electroporation, creating permanent pores in cancer cell membranes, which kill prostate cancer cells while preserving surrounding nerves, blood vessels, and connective tissue.
Most clinics use a fixed grid to guide electrode placement, but this assumes a flat, two-dimensional layout that rarely matches the true shape of a prostate tumour. At Vitus, our method is based on manual electrode placement refined over more than a decade of experience treating complex cases.
Each electrode is positioned under continuous ultrasound, allowing custom angles, real-time adjustments, and far greater control. Our goal is always the same: match the ablation zone to the actual three-dimensional tumour shape so only the cancer is treated while healthy structures are carefully preserved.
Treatment Process
Every NanoKnife treatment begins with detailed diagnostic imaging. At Vitus, this includes a multiparametric MRI reviewed by our prostate imaging team and a 3D saturation biopsy to identify all tumour foci.
Both tests are essential for defining the exact tumour boundaries, since NanoKnife itself does not detect cancer locations.
Our physicians and physicists then use the MRI and biopsy data, together with custom 3D simulations, to outline the ablation zone and prepare a precise treatment plan.
The procedure is performed under anesthesia so you remain completely comfortable.
Thin needle electrodes are inserted through the perineum and positioned around the tumour using continuous endorectal ultrasound guidance. Because the prostate is small and surrounded by important structures, precise placement is essential and requires significant experience.
Once the electrodes are correctly positioned, the NanoKnife system is programmed according to your treatment plan. When everything is aligned, short electrical pulses are delivered between the electrodes. These pulses last only a few millionths of a second, which prevents heat buildup and avoids thermal damage.
The pulse delivery phase itself takes only seconds or a few minutes.
After the electrodes are removed, the small puncture sites close immediately. Most patients experience little to no pain, although the bladder catheter placed before treatment can feel uncomfortable. The catheter is usually removed after 10 to 14 days.
Patients stay at the clinic for roughly 48 hours in total, with treatment on the second day and discharge the following morning. After discharge, most patients return to light daily activities shortly afterward.
It is common to notice small amounts of blood in the urine or seminal fluid for several weeks. This is a normal part of healing, as the body gradually clears the ablated tissue over the next few months.
Advantages of NanoKnife treatment
A short and gentle treatment.
- One time treatment in only one day
- Highest potency retention rate achieved to date*.
- Statistical 0% Incontinence**, ***
- No surgical incisions
- No aftercare necessary
- No higher recurrence rate than radical procedures**.
- Treatment even after ectomy or radiotherapy
- Secondary immunological benefits
- Most men (90-95 percent) treated with the NanoKnife procedure retain potency.
- ** Statistics obtained and published to date are based on 600 patients treated over 6 years. The Vitus Prostate Center is part of the multi-center registry study NCT02255890, but the results of this are still unpublished.
- * Urinary incontinence, as it is called, is the lack or inability of the body to safely store and self-directly empty the contents of the bladder. This leads to involuntary loss of urine. While there are several possible definitions of incontinence, a long-term study of incontinence after prostatectomy** concludes that a reasonable definition of incontinence is when a patient requires 2 or more pads per day 12 months after prostate surgery.
- **** Sacco E, Prayer-Galetti T, Pinto F, et al. Urinary incontinence after radical prostatectomy: incidence by definition, risk factors, and temporal trend in a large series with a long-term follow-up. BJU Int. 2006;97:1234-41.
- Syan, Raveen, and Victor W. Nitti. “Post-prostatectomy Incontinence Initial Evaluation.” Urinary Dysfunction in Prostate Cancer. Springer, Cham, 2016. 15-30.
Combination Therapies
While IRE with NanoKnife is our primary focus, it is not the only minimally invasive therapy we offer. Some patients benefit from combination therapies, especially in cases of recurrent prostate cancer or more complex tumour biology. At Vitus, we provide advanced focal techniques that can be paired with IRE when needed, including approaches that are available only at our centre.
View All Prostate Cancer Treatments →
IRECT (IRE + ECT)
IRECT is a combination therapy developed at Vitus Private Clinic that merges Irreversible Electroporation with Electrochemotherapy. It is designed for more advanced or difficult-to-reach prostate cancers, including recurrences after surgery, radiation, or HIFU.
During IRECT, part of the tumour is destroyed immediately through IRE, while surrounding areas receive short electrical pulses that enhance the uptake of a low-dose chemotherapeutic agent. This allows remaining cancer cells to be eliminated gradually over several weeks while preserving nearby nerves, vessels, and sphincter function.
Learn more about IRECT therapy →
Immunotherapy With Focal Therapy
At Vitus Private Clinic, IRE is paired with immunotherapy to support the body’s broader response to cancer. When IRE destroys tumour cells, the released tumour antigens enter the lymphatic system and help the immune system recognize cancer cells more effectively. This natural activation is strengthened with immunostimulatory medication to enhance the overall immune response.
The goal of combining IRE with immunotherapy is to support precise local tumour control while also helping the body identify and target cancer cells that may exist outside the primary treatment area.
Frequently Asked Questions
Men with prostate cancer confirmed through MRI and biopsy. Final eligibility depends on tumour location, imaging findings, and any previous treatments. Due to our experience pioneering innovative NanoKnife IRE techniques, many men who are not considered candidates at other centres can still be treated at Vitus. A review of your MRI and biopsy results is required.Contact our team to confirm candidacy →
Irreversible electroporation uses electrical pulses instead of heat or freezing, allowing tumour tissue to be treated without damaging nerves or surrounding structures. This helps preserve urinary and erectile function better than thermal treatments such as High Intensity Focused Ultrasound (HIFU) or cryotherapy.
Most men experience complete elimination of the targeted tumour area after a single treatment. Follow-up MRI and PSA testing are used to assess the treatment response. For appropriately selected patients, early and mid-term outcomes are comparable to radical treatments, with far fewer long-term side effects.
Most men experience only mild, short-term effects such as urinary discomfort, swelling, or temporary urinary retention. Because the treatment is non-thermal, long-term issues like incontinence or erectile dysfunction are far less common compared to surgery or radiation.
Yes. NanoKnife treatment does not limit future treatment options. If cancer returns or progresses, surgery or radiation can still be performed.
Follow-up usually includes regular PSA testing and MRI scans to evaluate the treatment area and detect any signs of recurrence. Many men complete follow-up with their local urologist, with support from the Vitus team.
Yes. IRE can be safely repeated if cancer returns or if a new tumour appears. The ability to repeat the procedure is one of the key advantages of prostate cancer focal therapy.