Menu
Home » Focal therapy » NanoKnife

NanoKnife Treatment for Prostate Cancer

  • NICE-approved (HTG688) non-thermal focal therapy for localised prostate cancer
  • 97% continence preserved, 90%+ sexual function maintained (FTC audit, n=265)
  • Treats anterior and lateral tumours that HIFU cannot reach — across 7 UK locations
Book your consultation View Our Locations
On this page
What is NanoKnife? Is NanoKnife right for me? NanoKnife success rates Advantages & Disadvantages What to Expect What are the side effects? Questions
Nice Approved
NICE Approved (HTG688)
2,500+
Focal Therapy
Treatments Completed
97% Continence Preserved
97% Continence
90%+ Sexual Function


Fast recovery
Outpatient procedure with quick recovery time (2-3 days)


Fewer side effects
Low risk of incontinence and erectile dysfunction


Minimally invasive
No hormones, radiation or incisions

NanoKnife (irreversible electroporation, IRE) is a NICE-approved (guidance HTG688) non-thermal focal therapy for prostate cancer that is localised. At The Focal Therapy Clinic, our consultant urological surgeons — led by a NanoKnife-accredited trainer — use precise electrical pulses to destroy the tumour while sparing the nerves, urethra and healthy tissue, preserving urinary continence in 97% of men and sexual function in over 90% (our audit, n=265).

NanoKnife Irreversible Electroporation (IRE) is a NICE-approved (HTG688) non-thermal focal therapy for localised prostate cancer. It uses precisely controlled electrical pulses to destroy cancerous cells while preserving surrounding healthy tissue, including nerves, blood vessels, and the urethra. NanoKnife is particularly effective for anterior and lateral prostate tumours that are difficult to reach with other focal therapy methods such as HIFU.

NanoKnife has been used to treat prostate cancer since 2008 and received NICE approval for prostate cancer treatment in 2022. In our clinic's experience (n=265), 97% of patients maintain urinary continence and over 90% preserve sexual function after focal therapy.

Which Consultants Perform the Procedure?

At The Focal Therapy Clinic, our consultant urologists have performed over 2,000 focal therapy procedures collectively, including NanoKnife IRE treatments across seven UK locations. Our consultant uro-radiologist team prepares precise treatment plans for each patient based upon a detailed review of their MRI and biopsy results. The use of these treatment plans in theatre ensures enhanced cancer control and reduced risk of urinary or erectile function side effects.


NanoKnife is one of two focal therapy treatments offered at The Focal Therapy Clinic. For posterior prostate tumours, HIFU treatment for prostate cancer may be more suitable. In some cases, both NanoKnife and HIFU are used in combination therapy to treat tumours in multiple prostate regions.

Book your consultation

Learn more about how NanoKnife works

Book your consultation

Mr Marc Laniado Who is NanoKnife suitable for
00:59
Playlist
Learn more about how NanoKnife Works
Book your consultation
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Focal therapy for prostate cancer at the front has even fewer side effects. It avoids nerves affecting erections and reduces rectal risks, making it an excellent minimally invasive treatment option that preserves quality of life while effectively treating cancer.

TRANSCRIPT
Mr Marc Laniado: If you are diagnosed with prostate cancer at the front of your prostate, one of the key advantages is that focal therapy in this area has even fewer potential side effects compared to other locations. Focal therapy already carries a low risk of side effects, but because the cancer is positioned at the front, it is well away from the nerves responsible for erections, making erectile dysfunction extremely unlikely. Additionally, the rectum is further away, reducing the risk of rectal side effects even more. NanoKnife focal therapy is particularly well-suited for men with cancers at the front of the prostate. In the past, these cancers often went undiagnosed until they were quite large, as MRI scans were not available. Now, with MRI, we are detecting these cancers much earlier, allowing men to benefit from targeted, minimally invasive treatment with excellent outcomes.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Raj Nigam: Is NanoKnife better than HIFU?
01:00
Playlist
Learn more about how NanoKnife Works
Book your consultation
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): HIFU and NanoKnife are chosen based on tumor location. HIFU treats the posterior prostate, while NanoKnife targets anterior tumors. Comparative data between them is still evolving, and the choice depends on tumor characteristics and patient preference. Raj Nigam - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-raj-nigam/ Nanoknife - https://www.thefocaltherapyclinic.co.uk/focal-therapy/nanoknife-ire-treatment/ HIFU - https://www.thefocaltherapyclinic.co.uk/focal-therapy/hifu-treatment-prostate-cancer/ 00:00 Using HIFU for Posterior Prostate Tumors 00:13 How NanoKnife Differs from HIFU 00:23 Why NanoKnife Is Used for Anterior Tumors 00:38 Is HIFU or NanoKnife Better? 01:00 Treatment Choice Based on Tumor Location 01:07 Future Research & Refining Treatment Selection

TRANSCRIPT
Mr. Raj Nigam: At present, we are using **HIFU** to treat tumors located in the **posterior part of the prostate**, which is **closest to the rectum**. This is because **HIFU energy is delivered through the rectum**. ### **How NanoKnife Differs** - **NanoKnife uses electrodes** placed through the **perineum** instead of the rectum. - This allows treatment in **any part of the prostate**, guided by **MRI-ultrasound fusion**. - Currently, we are using **NanoKnife for anterior (top) prostate tumors**, where it is **proven to be safe**. ### **Which Treatment is Better?** - We **do not yet have comparative data** showing whether **HIFU or NanoKnife** is superior. - **Treatment choice is based on tumor location**: - **HIFU for posterior tumors**. - **NanoKnife for anterior tumors**. As research continues, we aim to refine our approach and determine the **best treatment for different prostate cancer cases**.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Alan Doherty explains why NanoKnife is a safe and effective treatment for prostate cancer
00:34
Playlist
Learn more about how NanoKnife Works
Book your consultation
SUMMARY
Mr. Alan Doherty (Consultant Urologist, The Focal Therapy Clinic): NanoKnife is a powerful focal treatment that uses electricity to destroy cancer cells. With proper monitoring and expertise, it is a safe and effective option for treating prostate cancer while preserving healthy surrounding tissue. Alan Doherty - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-alan-doherty/ Nanoknife - https://www.thefocaltherapyclinic.co.uk/focal-therapy/nanoknife-ire-treatment/

TRANSCRIPT
Mr. Alan Doherty: **NanoKnife is a focal treatment that is considered safe when used properly**. ### **How NanoKnife Works** - It uses **electricity between electrodes** to **target and destroy cancer cells**. - **Precise monitoring** is essential to ensure the electrical pulses **only affect the intended area**. ### **Why Proper Execution Matters** - The **electricity must be carefully controlled** to avoid unintended damage. - The procedure requires **intensive monitoring** and **a deep understanding of the equipment**. When performed by **experienced specialists**, **NanoKnife is a safe and effective treatment** for **prostate cancer**, offering a **minimally invasive alternative** to radical therapies.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge How does NanoKnife work
00:35
Playlist
Learn more about how NanoKnife Works
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): NanoKnife destroys prostate cancer cells using electrical pulses while preserving surrounding healthy tissue. This minimally invasive approach offers effective treatment with fewer side effects, making it a valuable option for selected patients.

TRANSCRIPT
Mr Tim Dudderidge: NanoKnife works by placing needles in the prostate around the target lesion. Using electrical pulses, it creates tiny holes in the cells, disrupting their function and destroying the cancerous tissue. Once the electrical shocks are applied, the targeted tissue, including the cancer cells, is completely destroyed. This technique minimizes damage to surrounding healthy tissue, making it a treatment option with very few side effects.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Feature NanoKnife IRE
Treatment Type Minimally invasive focal therapy
Temporary swelling Common
Energy Used Electrical pulses (non-thermal)
Hospital Stay Outpatient (same day)
Cancer-free at 1 year 90% (FTC audit, n=265)
Urinary Continence 97% (FTC audit, n=265)
Sexual Function Preserved 90%+ (FTC audit, n=265)
Repeatable Treatment? Yes
Best for Tumour Location Tumours located at the front (anterior) of the prostate
Suitability Men eligible for focal therapy where tumour location is in the front of the prostate rather than the base of the prostate gland
Follow-Up Care Regular PSA testing and occasional MRI scans

Is NanoKnife right for me?

NanoKnife suits men with localised prostate cancer (Gleason 6–7, Grade Groups 1–3) that is clearly visible on multiparametric MRI. It is not recommended for high-grade (Gleason 8–10), multifocal or metastatic disease. Because it is non-thermal, NanoKnife is often chosen for anterior tumours or cancer near the urethra or nerves. At The Focal Therapy Clinic every case is MRI-reviewed by a consultant before treatment.

NanoKnife for Prostate Cancer is a minimally-invasive treatment for men with localised prostate cancer in parts of the prostate that are too hard for HIFU to reach. NanoKnife could be right for you if your prostate cancer is:

Early or intermediate stage

In the anterior or lateral parts of the prostate

Localised

Recurrent

It could also be the right choice if you are keen to avoid long-time side effects from prostate cancer treatment.

Read more about focal therapy eligibility.
Check your suitability

Success rates

In The Focal Therapy Clinic's audit (n=265), 90% of men were cancer-free at one year with 97% continence maintained. Published Australian biopsy-monitored data on focal NanoKnife (IRE) report failure-free survival of 91% at three years and 84% at five years (Scheltema et al., St Vincent's Sydney, 2023). For cancer that returns after radiotherapy, salvage IRE achieved 78% local control (FIRE trial, 2023). The Focal Therapy Clinic's own consultants co-authored a major salvage focal-therapy study (Light et al., JAMA Oncology, 2026).


NanoKnife has been shown to be effective for controlling cancer, potency and fertility.

91%

Cancer control (Scheltema et al., 2023)

91% failure-free survival at 3 years and 84% at 5 years (n=229, Australian biopsy-monitored cohort)

90%+

Sexual function

90%+ of men maintained sexual function after focal therapy (FTC audit, n=265)

97%

Urinary continence

97% maintained full urinary continence after focal therapy (FTC audit, n=265)

UK NanoKnife data (NEAT trial, Valerio et al., J Urol 2017, PMID 27697580) support 12-month safety and functional preservation, but UK 3- and 5-year NanoKnife outcome data are limited.

If the cancer is not fully treated or returns, NanoKnife can be repeated or followed by surgery or radiotherapy.

Mr Marc Laniado: MRI US Fusion technology and focal therapy success rates
01:00
Playlist
NanoKnife (IRE) Focal Therapy for Prostate Cancer
Book your consultation
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): MRI fusion improves focal therapy accuracy, ensuring over 90% of men are cancer-free at one year. Globally, 7580% of men avoid radical treatment for 610 years post-focal therapy, making it an effective and minimally invasive option for prostate cancer. Marc Laniado - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-marc-laniado/ MRI US Fusion Technology - https://www.thefocaltherapyclinic.co.uk/focal-therapy/medical-suitability/mri-scans-prostate-cancer/ Success Rates - https://www.thefocaltherapyclinic.co.uk/focal-therapy/success-and-clinical-evidence/ 00:00 Introduction: MRI Fusion in Focal Therapy 00:04 Why MRI Fusion Matters (Precision & Accuracy) 00:14 One-Year Success Rates (Over 90% Cancer-Free) 00:22 Long-Term Success of Focal Therapy (Global Data) 00:34 Avoiding Radical Treatments (610 Years Control) 00:52 Key Takeaway: Precise, Minimally Invasive & Effective

TRANSCRIPT
Mr. Marc Laniado: At **The Focal Therapy Clinic**, we perform **focal therapy using MRI fusion**, which significantly improves **treatment accuracy**. ### **Why MRI Fusion Matters** - We use **real-time MRI guidance** during treatment to **precisely target the cancer**. - This ensures we treat **the cancerous area and a surrounding margin**, reducing the risk of recurrence. - As a result, **our one-year success rates are excellent**—**over 90% of men are cancer-free** based on **MRI and PSA criteria**. ### **Long-Term Success of Focal Therapy** - Looking at global data, **focal therapy (often without MRI fusion) has been shown to delay or avoid radical treatment**. - **75–80% of men remain free from needing surgery or radiotherapy for 6–10 years after treatment**. - This means that **4 out of 5 men successfully avoid radical treatment while maintaining cancer control**. These **strong results** highlight the **effectiveness of MRI-guided focal therapy** in providing **precise, minimally invasive treatment with excellent long-term outcomes**.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.

NanoKnife: Advantages and Disadvantages

Because NanoKnife is non-thermal, it can treat tumours close to the urethra, nerves and rectum that heat-based treatments must avoid — making it particularly suited to anterior tumours. In The Focal Therapy Clinic's audit (n=265), 97% of men stayed fully continent and over 90% preserved sexual function, and because the prostate is preserved the treatment can be repeated if needed.


Advantages

  • Minimally invasive - No incisions, no radiation, no hormones
  • Preserves sexual function & continence - spares nerves and urinary structures
  • Outpatient procedure - Go home the same day. Rapid recovery
  • Repeatable if needed - Can be combined with other treatments
  • Effective cancer control - equivalent to radiotherapy or surgery at 8 years

Disadvantages

  • Not suitable for all cancers - Best for localised, clearly visible tumours (Gleason 7 or lower)
  • Follow-up monitoring required - Regular PSA testing and MRI scans needed
  • Limited long-term data - NanoKnife is newer than traditional treatments, though 8-year outcomes are comparable
Book your consultation View our locations

What to Expect Before, During, and After NanoKnife Treatment

  • MRI and biopsy to confirm eligibility
  • Pre-Procedure instructions (e.g. fasting)
      • Mr Tim Dudderidge: How should I prepare for focal therapy
      00:25
      Playlist
      Care: Before Treatment
      Book your consultation
      SUMMARY
      Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Before focal therapy, youll receive fasting instructions and arrival details. Avoid a heavy meal the night before, and if you have any questions, check with the ward nurses to ensure youre fully prepared for your procedure. Tim Dudderidge - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-tim-dudderidge/ Focal Therapy Process - https://www.thefocaltherapyclinic.co.uk/focal-therapy/ Care Pathway - https://www.thefocaltherapyclinic.co.uk/process/

      TRANSCRIPT
      Mr. Tim Dudderidge: Before your **focal therapy procedure**, you will receive **specific fasting instructions** and **your hospital arrival time** from the booking team. ### **Pre-Treatment Preparation** - Follow the **fasting instructions** provided. - If you're **unsure about any details**, check with **ward nurses in advance**. - Avoid eating a **heavy meal the night before** your procedure. - Pack a **small bag with essentials** for your hospital visit. Aside from these simple steps, **there is very little preparation required** for focal therapy.

      This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge: What happens on the day of a focal therapy treatment?
01:37
Playlist
Care: On the Day
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy is a day-case procedure performed under general anesthesia, typically lasting 6090 minutes. A catheter is required for 57 days, and most patients resume normal activities soon after, making it a minimally invasive and efficient treatment option. 00:00 Introduction Mr. Tim Dudderidge introduces what to expect on the day of focal therapy. 00:01 Arrival & Preparation Arrive starved for anesthesia, nursing checks, and enema for ultrasound clarity. 00:21 Procedure Details Transferred to theater, anesthetized, procedure lasts 6090 minutes. 00:32 Post-Procedure Recovery Wake in recovery, food & drink provided, catheter management explained. 00:53 Going Home & Recovery Must be driven home, catheter stays 57 days, most men return to normal life soon after removal. 01:38 Key Takeaway Focal therapy is a straightforward day-case procedure with quick recovery. Tim Dudderidge - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-tim-dudderidge/ Focal therapy timeline - https://www.thefocaltherapyclinic.co.uk/focal-therapy/

TRANSCRIPT
Mr. Tim Dudderidge: ### **On the Day of Your Focal Therapy Procedure** 1. **Arrival & Pre-Procedure Preparation** - You will **arrive at the hospital starved**, ready for **general anesthesia**. - Nursing staff will **greet you and perform necessary checks**. - An **enema will be administered** to clear the bowels, ensuring a **clear ultrasound view** during treatment. 2. **Procedure Details** - You will be **transferred to the operating theater**, where final checks are completed. - Once the **anesthetist is happy**, you will be placed under **general anesthesia**. - The **procedure lasts 60–90 minutes**, during which the targeted prostate area is treated. 3. **Post-Procedure Recovery** - After the procedure, you will **wake up in the recovery room**, spending about **30 minutes there** before returning to the ward. - You will be given **food and drink** once fully awake. - A **catheter** will be attached to your leg, and **nurses will show you how to manage it**. 4. **Going Home & Recovery** - Once you have **fully recovered from anesthesia**, you can go home, but **someone must drive you** as you **cannot drive for 36 hours**. - **Normal activities can resume**, but the **catheter will stay in for 5–7 days**. - After **catheter removal**, most men can **return to normal life with minimal restrictions**. ### **Key Takeaway** Focal therapy is a **straightforward day-case procedure**, and **recovery is quick**, allowing patients to **resume daily life within a week**.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge: Do I need a general anaesthetic for focal therapy
00:46
Playlist
Care: On the Day
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): **Most patients can safely undergo general anesthesia for HIFU, NanoKnife, and cryotherapy**. **Spinal anesthesia is not suitable for HIFU or NanoKnife but may be an option for cryotherapy**. Tim Dudderidge - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-tim-dudderidge/ Care Pathway - https://www.thefocaltherapyclinic.co.uk/process/ Focal Therapy - https://www.thefocaltherapyclinic.co.uk/focal-therapy/

TRANSCRIPT
Mr. Tim Dudderidge: Nearly all patients can safely undergo the **general anesthesia required for a HIFU procedure**. ### **Anesthesia for Focal Therapy Treatments** - **HIFU (High-Intensity Focused Ultrasound)** - Requires **general anesthesia**. - **Spinal or regional anesthesia is not suitable**, as past attempts have not worked well. - This was learned from **early experiences**, and general anesthesia is now the standard. - **Cryotherapy** - Can potentially be performed under **spinal anesthesia**, but general anesthesia is preferred. - **NanoKnife (Irreversible Electroporation)** - Requires **general anesthesia** due to **muscle effects during the procedure**. For patients considering **focal therapy**, general anesthesia is **safe and well-tolerated in nearly all cases**, ensuring **optimal treatment conditions**.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge: What happens during focal therapy
01:38
Playlist
Care: On the Day
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy procedures last 6090 minutes under anesthesia, using MRI-ultrasound fusion to precisely target cancer. HIFU, cryotherapy, and NanoKnife effectively destroy cancer cells while preserving healthy tissue, offering a minimally invasive alternative to surgery or radiotherapy. Tim Dudderidge - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-tim-dudderidge/ Focal Therapy - https://www.thefocaltherapyclinic.co.uk/focal-therapy/ 00:00 Focal Therapy Procedure Overview (Anesthesia & Positioning) 00:07 Imaging & Treatment Planning (MRIUltrasound Fusion) 00:40 HIFU Treatment Explained (Heat-Based Therapy) 00:59 Cryotherapy & NanoKnife (Needle-Based Therapies) 01:25 Procedure Duration & Recovery (6090 Minutes, Catheter Placement) 01:30 Key Benefit: Precision with Functional Preservation

TRANSCRIPT
Mr. Tim Dudderidge: During a **typical focal therapy procedure**, you will be **asleep under general anesthesia**, with your legs positioned in **lithotomy** to allow access to the **perineum**. ### **Imaging & Treatment Planning** - A **transrectal ultrasound probe** is placed in the rectum. - In **HIFU**, this is the **treatment probe**; in **cryotherapy and electroporation (NanoKnife)**, it is a **standard ultrasound probe**. - The **ultrasound images are linked to your MRI scan** to identify the lesion and ensure **precise targeting**. - The treatment is planned with a **margin around the lesion**, capturing all cancer cells, including any microscopic “tentacles” of disease. ### **Treatment Procedures** 1. **HIFU (High-Intensity Focused Ultrasound)** - Uses **overlapping treatment zones**, typically **three or four sessions**, where heat destroys the cancer cells. - A **urethral catheter** is placed at the end of the procedure. 2. **Cryotherapy & NanoKnife (Electroporation)** - Involve placing **needles into the prostate** at various locations. - **Cryotherapy freezes cancer cells**, while **NanoKnife uses electrical pulses** to destroy tissue. - **MRI-ultrasound fusion** ensures accurate targeting and a sufficient **treatment margin**. ### **Procedure Duration & Recovery** - The treatment typically lasts **60–90 minutes**. - A **catheter is placed at the end of the procedure** to aid recovery. Focal therapy is **highly precise**, ensuring **effective cancer control** while preserving **urinary and sexual function** as much as possible.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge: Recovery after focal therapy
01:04
Playlist
Care: Recovery
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Pain after focal therapy is uncommon, but bladder spasms are the most frequent discomfort, typically lasting 2448 hours. Antispasmodic drugs and simple painkillers help manage symptoms, ensuring a smoother recovery. Mr Alan Doherty - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-alan-doherty/ recovery from Focal Therapy - https://www.thefocaltherapyclinic.co.uk/why-choose-focal-therapy/recovery/ patient stories - https://www.thefocaltherapyclinic.co.uk/about-us/prostate-cancer-stories/ care pathway - https://www.thefocaltherapyclinic.co.uk/process/ 00:00 Introduction: Recovery After Focal Therapy 00:01 Pain Is Not Typically a Major Symptom 00:04 Most Common Side Effect: Bladder Spasms 00:08 Description: Urge to Urinate Despite Proper Drainage 00:20 Duration: Usually Temporary (2448 Hours) 00:27 Management with Antispasmodic Drugs (e.g., Buscopan) 00:38 Other Options: Targeted Bladder Medications 00:43 Managing Pain & Recovery 00:50 Mild Pain from Perineal Bruising 00:52 Relief with Simple Painkillers (Paracetamol, Ibuprofen)

TRANSCRIPT
Mr. Tim Dudderidge: After a **focal therapy procedure**, **pain is not typically a major symptom**. ### **Most Common Side Effect: Bladder Spasms** - The most frequent discomfort is **bladder spasms**—a **strong urge to urinate** even though the **catheter is draining properly**. - This symptom is usually **temporary**, lasting **24–48 hours**. - It can be managed with: - **Antispasmodic drugs** like **Buscopan (hyoscine butylbromide)**. - **More targeted bladder medications**. ### **Managing Pain & Recovery** - **Pain is usually mild** and related to **bruising in the perineum**. - **Paracetamol and ibuprofen*

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge Will I need to wear a pad after focal therapy
00:32
Playlist
Care: Recovery
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Post-surgery pad use is usually due to sphincter damage, leading to long-term incontinence risks. In contrast, focal therapy may cause only temporary urgency-related leakage, with most patients regaining full bladder control quickly. Website: https://www.thefocaltherapyclinic.co.uk LinkedIn: linkedin.com/company/the-focal-therapy-clinic/ Facebook: facebook.com/TheFocalTC Telephone: +44 (0) 207 036 8870 #FocalTherapy #ProstateHealth #MinimallyInvasive #MensHealth #ProstateCancerTreatment #Urology

TRANSCRIPT
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Typically, the reason men have to wear pads after surgery is due to sphincter damage, which can take a long time to heal. Occasionally, men may experience some frequency and urgency after focal therapy treatments, where an overactive bladder can lead to leakage just before reaching the toilet. For these men, wearing a pad is a temporary issue and usually short-lived.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge How long does it take to recover from focal therapy
01:25
Playlist
Care: Recovery
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Recovery after focal therapy is quick. Most patients resume light activities within a week and return to normal physical activity soon after. Some may experience temporary urgency or fatigue, but side effects are typically mild compared to traditional treatments.

TRANSCRIPT
Mr Tim Dudderidge: After focal therapy, you can drive again after 48 hours as long as the catheter is not causing significant discomfort. However, if the catheter is bothersome or distracting, it is best to wait until it has been removed before driving. During the first week after treatment, you can engage in most light activities, and we encourage plenty of walking to stay active. Once the catheter is removed, patients can typically return to normal physical activities, including sports. I have had patients go skiing soon after catheter removal, and one even sent me a video of himself playing ice hockey just 10 days after treatment. Regarding work, recovery varies depending on your job. Many office-based workers are able to work on their laptops while still in the hospital. If you are self-employed, you may find it easy to return to work quickly. However, if your job is physically demanding, you might need a couple of weeks to adjust, as bladder behavior can be slightly more frequent or urgent at first. Beyond that, recovery is generally very quick. Some people experience mild fatigue after treatment, which can be surprising. It is important to listen to your body and gradually return to normal activity at a comfortable pace.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge: When can I go home after focal therapy
00:40
Playlist
Care: After your treatment
Book your consultation
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Most patients go home within a few hours after focal therapy, once theyve eaten, had fluids, and been shown how to use the catheter. Those traveling far may choose to stay in a nearby hotel overnight for added convenience and comfort. Mr Tim Dudderidge - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-tim-dudderidge/ Recovery after Focal Therapy - https://www.thefocaltherapyclinic.co.uk/why-choose-focal-therapy/recovery/ Book your consultation - https://www.thefocaltherapyclinic.co.uk/contact/ 00:00 Introduction: Pain After Focal Therapy 00:04 Common Side Effect: Bladder Spasms 00:08 What Bladder Spasms Feel Like (Urgency Despite Catheter Drainage) 00:20 Duration of Symptoms: Usually 2448 Hours 00:27 Managing Discomfort: Antispasmodic Medications (Buscopan) 00:38 Targeted Bladder Medications 00:43 Pain Management & Recovery Tips 00:50 Mild Pain or Bruising: Paracetamol and Ibuprofen Recommended Website: https://www.thefocaltherapyclinic.co.uk LinkedIn: linkedin.com/company/the-focal-therapy-clinic/ Facebook: facebook.com/TheFocalTC Telephone: +44 (0) 207 036 8870 #FocalTherapy #ProstateCancer #MensHealth #MinimallyInvasive #CancerRecovery #ProstateHealth

TRANSCRIPT
Mr. Tim Dudderidge: Most patients **go home within a few hours** of returning to the ward after **focal therapy**. ### **What to Expect Before Discharge** - You’ll have time to **eat and drink**. - You’ll be **shown how to use the catheter**. - We’ll ensure you **don’t feel too groggy** before leaving. ### **Evening Procedures & Travel Considerations** - We often schedule procedures for the **late afternoon (Twilight list at 6:00 PM)**. - Even if treated late, **most patients can still go home that evening**, often around **9:00 PM**. - **For those traveling a long distance**, we may recommend **staying overnight in a local hotel** and traveling home the next morning. Most men **recover comfortably at home**, with clear instructions on **aftercare and follow-up**.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado: Will I need help getting or maintaining an erection after focal therapy?
00:41
Playlist
Care: After your treatment
Book your consultation
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Most men regain normal erections within a few months after focal therapy, though medications can help. By one year, function is usually restored, with rare cases needing further treatment or additional support. Mr Marc Laniado - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-marc-laniado/ sex and relationships - https://www.thefocaltherapyclinic.co.uk/why-choose-focal-therapy/sex-and-relationships/ prostate cancer and ejaculation - https://www.thefocaltherapyclinic.co.uk/blog/does-prostate-cancer-stop-you-from-ejaculating/

TRANSCRIPT
Mr. Marc Laniado: If you had **completely normal erections** before treatment, most men find that their **erections return within a few months** after focal therapy. ### **How to Support Recovery** I usually recommend taking a **low-dose erectile function medication. This helps: - **Boost blood flow to the nerves and penis**. - **Improve recovery and support erectile function return**. ### **What to Expect Over Time** - By **one year**, most men find their erections are **normal or close to normal**. - **Some men may need to continue taking medication** for erections even if they didn’t before. - **Very rarely**, men require additional treatments such as **injections or other interventions**, but this is uncommon. With **proper support and time**, **most men regain their sexual function after focal therapy**, maintaining a **high quality of life**.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Raj Nigam After focal therapy what tests are done to see if it was effective
01:38
Playlist
Care: After your treatment
Book your consultation
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): We closely monitor all focal therapy patients with regular PSA tests and MRI scans to track treatment success. If recurrence occurs (510%), further focal therapy or traditional treatments like surgery or radiotherapy remain viable options, ensuring flexible and effective cancer management.

TRANSCRIPT
Mr Raj Nigam: We carefully follow up with all our focal therapy patients. It is essential that after your treatment, you have access to us for ongoing monitoring. We track your progress in two ways. First, we conduct PSA blood tests every three months for the first year. Even if your PSA levels drop significantly and you feel completely fine, we always perform an MRI scan at the end of the first year. This ensures that the treated area has disappeared and that no new abnormalities have developed in the remaining prostate tissue. If everything looks good, we transition to six-monthly PSA tests for the next two years, followed by annual PSA checks. Many men also opt for another MRI scan at three or five years, which is entirely possible, though we primarily rely on PSA levels to guide further imaging needs. In the unfortunate 5–10% of cases where the cancer is not fully treated or returns in another part of the prostate, additional options are available. You can undergo another focal therapy session or pursue traditional treatments such as radical prostatectomy or radiotherapy if needed.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.

Side effects & Risks

After NanoKnife, over 90% of men maintain sexual function and 97% remain fully continent (our audit, n=265).

Symptom Frequency Duration
Urinary Catheter required Always 3-5 Days
Mild discomfort in perineum area Common 2-3 Days
Temporary swelling and bruising Common 2-3 Weeks
Blood in urine or semen Common Up to 8 weeks
Change in erectile function Uncommon — over 90% of men maintain sexual function (FTC audit, n=265) Usually temporary
Return to normal Common 3 - 7 days
Side effects

Questions to ask your doctor or nurse

Is my cancer localised, clearly visible on MRI, and Gleason 7 or lower — suitable for NanoKnife?
Is NanoKnife better than HIFU for the position of my tumour (e.g. anterior)?
What does your clinic's audited data show for continence and sexual function after NanoKnife?
Who will perform my treatment, and are they a NanoKnife-accredited trainer?
If the cancer returns, can NanoKnife be repeated, or would I need surgery or radiotherapy?
Is NanoKnife NICE-approved for my situation (HTG688), and am I eligible?
What follow-up (PSA, MRI) will I have, and for how long?

Get Expert Advice & The Latest Research

Subscribe to our newsletter to receive the latest updates, expert insights, and breakthrough research on prostate cancer-delivered straight to your inbox.

    Choosing Between NanoKnife & HIFU: Key Factors

    NanoKnife and HIFU are both NICE-approved focal therapies at The Focal Therapy Clinic; the right choice depends on where the tumour sits. HIFU (HTG667) uses focused ultrasound and suits posterior or lateral tumours; NanoKnife (HTG688) is non-thermal and suits anterior tumours or cancer close to the urethra or nerves. Both preserve continence in around 97% of men and sexual function in over 90% (our audit, n=265). compare NanoKnife and HIFU

    The Role of MR-US Fusion Technology in Treatment Accuracy

    MRI-Ultrasound (MR-US) Fusion Technology combines high-resolution MRI imaging with real-time ultrasound guidance, allowing for precise targeting of cancerous tissue.

    Benefits of MR-US Fusion Technology

    • Improved Tumour Detection - More accurate than ultrasound alone
    • Greater Targeting Precision - Helps specialists precisely pinpoint tumours
    • Reduces Risk of Missing Cancerous Tissue - Ensures comprehensive tumour destruction
    Diagram of MR-US fusion technology benefits: improved tumour detection, greater targeting precision, enhanced treatment accuracy and reduced risk of missing cancerous tissue

    Mr Marc Laniado: MRI US Fusion technology and focal therapy success rates
    01:00
    Playlist
    NanoKnife (IRE) Focal Therapy for Prostate Cancer
    Book your consultation
    SUMMARY
    Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): MRI fusion improves focal therapy accuracy, ensuring over 90% of men are cancer-free at one year. Globally, 7580% of men avoid radical treatment for 610 years post-focal therapy, making it an effective and minimally invasive option for prostate cancer. Marc Laniado - https://www.thefocaltherapyclinic.co.uk/about-us/our-consultants/mr-marc-laniado/ MRI US Fusion Technology - https://www.thefocaltherapyclinic.co.uk/focal-therapy/medical-suitability/mri-scans-prostate-cancer/ Success Rates - https://www.thefocaltherapyclinic.co.uk/focal-therapy/success-and-clinical-evidence/ 00:00 Introduction: MRI Fusion in Focal Therapy 00:04 Why MRI Fusion Matters (Precision & Accuracy) 00:14 One-Year Success Rates (Over 90% Cancer-Free) 00:22 Long-Term Success of Focal Therapy (Global Data) 00:34 Avoiding Radical Treatments (610 Years Control) 00:52 Key Takeaway: Precise, Minimally Invasive & Effective

    TRANSCRIPT
    Mr. Marc Laniado: At **The Focal Therapy Clinic**, we perform **focal therapy using MRI fusion**, which significantly improves **treatment accuracy**. ### **Why MRI Fusion Matters** - We use **real-time MRI guidance** during treatment to **precisely target the cancer**. - This ensures we treat **the cancerous area and a surrounding margin**, reducing the risk of recurrence. - As a result, **our one-year success rates are excellent**—**over 90% of men are cancer-free** based on **MRI and PSA criteria**. ### **Long-Term Success of Focal Therapy** - Looking at global data, **focal therapy (often without MRI fusion) has been shown to delay or avoid radical treatment**. - **75–80% of men remain free from needing surgery or radiotherapy for 6–10 years after treatment**. - This means that **4 out of 5 men successfully avoid radical treatment while maintaining cancer control**. These **strong results** highlight the **effectiveness of MRI-guided focal therapy** in providing **precise, minimally invasive treatment with excellent long-term outcomes**.

    This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.

    A consultation with a prostate cancer specialist is necessary to determine the best treatment choice.
    Book your consultation

    Frequently asked questions

    There are many factors to consider when choosing a treatment for your prostate cancer. Medical factors, such as your cancer stage and tumour location are important. However, your current and future quality of life is also very important.


    What is NanoKnife (IRE)?
    A NICE-approved (HTG688) non-thermal focal therapy that destroys prostate cancer with precise electrical pulses, sparing nerves and healthy tissue; at FTC, 97% of men stay continent and over 90% keep sexual function (audit, n=265).
    Is NanoKnife better than HIFU?
    Neither is better overall; the choice depends on tumour position — NanoKnife (non-thermal) suits anterior tumours or cancer near the urethra/nerves; HIFU suits posterior/lateral tumours.
    What is the success rate of NanoKnife?
    In FTC's audit (n=265), 90% of men were cancer-free at one year with 97% continence; published Australian data report failure-free survival of 91% at 3 years and 84% at 5 years (Scheltema et al., 2023). Salvage IRE after radiotherapy is also a recognised option.
    How much does NanoKnife cost?
    See our NanoKnife cost page; treatment is medical-insurance backed.
    Can NanoKnife be repeated?
    Yes; because the prostate is preserved, NanoKnife can be repeated or followed by surgery or radiotherapy if needed.
    Am I suitable for NanoKnife?
    Typically men with localised cancer (Gleason 6–7) clearly visible on MRI; not for high-grade, multifocal or metastatic disease; every case is MRI-reviewed by a consultant.
    Book your consultation

    Sources

    Our outcomes are from The Focal Therapy Clinic's audit of 265 patients (1-year follow-up): 97% urinary continence, 90%+ sexual-function preservation, 90% cancer-free at one year.

    Published NanoKnife (IRE) primary outcomes: Scheltema MJ, … Stricker PD. Median 5-year outcomes of primary focal IRE. BJU Int 2023;131(S4):6–13 (doi:10.1111/bju.15946; n=229; failure-free survival 91% at 3 yrs, 84% at 5 yrs, 69% at 8 yrs) — the primary long-term cohort; an earlier series (Blazevski A, … Stricker P. Eur Urol Oncol 2020;3(3):283–290; n=123) reported 96.75% at 3 yrs.

    Salvage IRE: Blazevski A, … Stricker PD. FIRE trial. BJU Int 2023;131(S4):23–31 (doi:10.1111/bju.15947; 78% local control).

    UK NanoKnife (12-month safety): Valerio M et al. NEAT trial. J Urol 2017;197(3):647–654. (Australian primary/salvage IRE data — not FTC-authored; UK long-term NanoKnife data are limited.)

    FTC consultants' salvage research: Light A, … Dudderidge T, Nigam R, Laniado M, et al. JAMA Oncology 2026;12(4):364–373 (doi:10.1001/jamaoncol.2025.6448) — co-authored by FTC's Mr Dudderidge, Mr Nigam and Mr Laniado (HIFU/cryotherapy salvage).

    Older men: Habashy D, … Nigam R, … Dudderidge T. J Urol 2023;210(1):108–116.

    Regulatory: NICE HTG688 (2023); NG131 (2019, upd. 2021); EAU 2024.

    Subscribe to our newsletter

    Get expert advice & the latest prostate cancer research - straight to your inbox.

      We care about your data in our privacy policy.
      Chat with PIP, The Focal Therapy Clinic's prostate information chatbot