(O-02) Midterm Sexual and Oncologic Outcomes of Irreversible Electroporation (Nanoknife) for Localized Low- and Intermediate-Risk Prostate Cancer: A Prospective Single-Arm Study (oral)

Abstract Background Irreversible electroporation (IRE, Nanoknife) is a minimally invasive focal therapy for localized prostate cancer that aims to achieve oncological control while preserving urinary and sexual function — outcomes of particular importance in sexual medicine practice. This study aims to evaluate the sexual, functional, and oncological outcomes of IRE. Methods In this prospective single-arm study, Functional outcomes were assessed using the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) at baseline, 3 months, and 6 months. Oncologic control was evaluated via PSA changes. Wilcoxon signed-rank tests compared paired values. Results 21 male with low- and intermediate-risk localized prostate cancer (Gleason Grade Group 1–3, PIRADS 3–5) underwent focal IRE. Median age was 62.5 years, median PSA 8 ng/mL (IQR 4–20), and mean prostate volume 43.1 mL. Median PSA decreased from 8 to 3.5 ng/mL at both 3 and 6 months (absolute change −4.28 and − 5.2; −55% and − 45.24%, p = 0.00 and p = 0.008). IPSS improved from 8 to 3 at both follow-ups (−62.5%, p = 0.004 and p = 0.045). IIEF scores rose slightly at 3 months (+6.5%, p = 0.443) but declined at 6 months (−28.2%, p = 0.003). Conclusions IRE provided effective short- to midterm oncologic control and significant urinary symptom improvement. Sexual function was maintained at 3 months but declined at 6 months, underscoring the need for long-term monitoring and potential rehabilitation strategies.