{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:17:41Z","timestamp":1787735861548,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"abstract":"<jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Irreversible electroporation (IRE) is an emerging non\u2010thermal focal therapy for localized prostate cancer (PCa), offering tissue\u2010selective ablation with functional preservation. This review aimed to delineate the \u2018ideal\u2019 candidate for primary IRE and provide practical guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review (2014\u20132025) of primary IRE for localized PCa was conducted, including prospective series, multicentre registries, comparative studies, and systematic reviews. We synthesized baseline characteristics, lesion features, ablation strategy, oncologic\/functional outcomes, and complications, focusing on cancer control and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The best outcomes were reported in men with magnetic resonance imaging\u2013visible, organ\u2010confined intermediate\u2010risk (International Society for Urological Pathology [ISUP] 2\u20133) PCa, typically presenting a single dominant unilateral index lesion characterized by multiparametric MRI and biopsy. Contemporary series show in\u2010field ablation of clinically significant cancer in ~80\u201390% with high functional preservation. The main limitation is out\u2010of\u2010field recurrence (~15\u201325% of failures), reflecting PCa multifocality. In\u2010field persistence at 12\u2009months was ~16% in the PRESERVE trial. Lesion size is a key practical constraint; current evidence and electrode geometry favour targets generally \u226420\u2009mm. Limited comparative evidence, largely from a single study, suggests better oncologic control with hemi\u2010gland IRE (clinically significant PCa persistence 8.6%) versus focal ablation (25%), whereas focal IRE better preserves erectile function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Implications<\/jats:title>\n                    <jats:p>\n                      Primary IRE appears safe and effective in selected localized PCa. The ideal candidate has unilateral MRI\u2010visible, organ\u2010confined ISUP 2\u20133 disease, prostate\u2010specific antigen density &lt;0.15\u20130.20\u2009ng\/mL\/cm\n                      <jats:sup>3<\/jats:sup>\n                      , and a lesion small enough for reliable electrode coverage. Hemi\u2010gland templates may improve oncologic reliability, whereas focal ablation maximizes functional outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Summary<\/jats:title>\n                    <jats:p>IRE is a focal, non\u2010thermal treatment for localized PCa that can control the treated lesion while usually preserving urinary continence and often erectile function. Cancer can still occur elsewhere in the prostate after treatment, so follow\u2010up is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70436","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:19:49Z","timestamp":1787732389000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying the ideal candidate for irreversible electroporation in localized prostate cancer: a comprehensive narrative review from the\n                    <scp>EAU<\/scp>\n                    Section of Endourology"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1873-4032","authenticated-orcid":false,"given":"Raffaele","family":"La Mura","sequence":"first","affiliation":[{"name":"Department of Urology Institut M\u00e9dico\u2010chirurgical Montsouris  Paris France"},{"name":"Urology Clinic, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Maiolino","sequence":"additional","affiliation":[{"name":"Department of Urology, C\u00e1tedra UFV\u2010The Lyx Institution en Salud Urol\u00f3gica Universidad Francisco de Vitoria  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7580-1066","authenticated-orcid":false,"given":"Julien","family":"Anract","sequence":"additional","affiliation":[{"name":"Department of Urology Hopital Cochin  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Valerio","sequence":"additional","affiliation":[{"name":"Department of Urology, Geneva University Hospital University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3067-2409","authenticated-orcid":false,"given":"Clement","family":"Orczyk","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2334-5207","authenticated-orcid":false,"given":"Ben","family":"Vanneste","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Ghent University Hospital  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5593-5995","authenticated-orcid":false,"given":"Federico","family":"Zorzi","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9 Service d'Urologie, AP\u2010HP, H\u00f4pital Tenon  Paris 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