As men get older, the prostate gland, which sits just below the bladder and surrounds the urethra, begins to enlarge. This condition is called benign prostatic hyperplasia (BPH).
BPH isn’t cancer, but its symptoms can still cause ongoing discomfort. Frequent trips to the bathroom, waking up multiple times at night, and a weak or hesitant urine stream are all common signs.
For some men, these problems slowly worsen over time if nothing is done.
When medications don’t provide enough relief or cause side effects, you might be advised to consider a procedure. One option is prostatic artery embolization (PAE). This is a minimally invasive treatment that has been shown to improve urinary symptoms in many men with BPH.
What Is PAE Procedure for Enlarged Prostate?
PAE, or prostatic artery embolization, is performed by an interventional radiologist. The doctor uses imaging, like X-rays, to guide small instruments through blood vessels. This allows conditions to be treated without the need for traditional surgery. Instead of cutting into the prostate, the procedure works by blocking blood flow to specific areas of the gland. The lack of blood flow causes it to shrink gradually. As the prostate becomes smaller, it presses less on the urethra, which helps urine flow more freely.
The procedure is usually done through a tiny puncture in the skin at the groin or wrist. A thin tube called a catheter is threaded into the arteries that supply the prostate. Tiny particles, called microspheres, are released to reduce the blood supply. Because the prostate itself is never cut or removed, recovery tends to be faster than with a surgical procedure.
How Does PAE Improve Urinary Symptoms?
With PAE, you won’t experience instant results.
Instead, the prostate shrinks gradually. Symptom relief develops over several weeks, with the greatest benefit felt after three to six months.
After treatment, men often notice:
- A stronger, steadier urine stream instead of one that feels weak or stops and starts
- Less difficulty getting started when trying to urinate
- Fewer sudden urges and more control over when you go
- More restful sleep at night with fewer trips to the bathroom
- A more complete emptying of the bladder without that lingering full feeling
- Less dribbling or leakage
Am I a Candidate For PAE?
To determine if you are a candidate, you will meet with your urologist for a thorough evaluation. Imaging before the procedure is an important step in planning. It helps your doctor see the blood vessels around the prostate and confirm that the treatment can be done safely. Your doctor will also assess your:
- Overall health
- Medical history
- Medications
Many factors go into the decision-making process, but, in general, PAE may be considered if:
- You have moderate to severe urinary symptoms from BPH
- You cannot tolerate, or prefer not to take, long-term medication
- You want to avoid more invasive surgical procedures
- Preserving sexual function, including ejaculation, is important to you
- You are not a good candidate for surgery because of other medical conditions
Prostate Artery Embolization Side Effects
The PAE procedure is performed with sedation, making sure you stay comfortable throughout. A small catheter is inserted through the wrist or groin, guided by X-ray imaging to reach the prostate arteries.
Once in position, the microsphere particles are slowly injected.
The procedure usually lasts one to two hours.
What Can I Expect After the Procedure?
Most men go home the same day. It’s normal to have mild pelvic cramping, burning with urination, or fatigue for a few days afterward.
Some men also develop a low-grade fever or flu-like feeling called post-embolization syndrome. This typically resolves within a week. While heavy lifting or strenuous exercise should be avoided for about a week, most men are able to return to normal activities in a few days.
What Are the Benefits of PAE?
Compared with traditional surgical treatments like transurethral resection of the prostate (TURP), PAE offers:
- No cutting into the prostate, which reduces risks of bleeding or scarring
- Lower chance of sexual side effects, particularly retrograde ejaculation
- A shorter recovery time, as most men will resume daily activities in just a few days
Prostatic Artery Embolization Side Effects
Like all procedures, PAE carries some risks, although they are generally low. Possible side effects include:
- Mild pelvic discomfort, burning with urination, or fatigue for a few days
- Temporary urinary retention, which may require a short-term catheter
- Blood in the urine or semen for several days
- Low-grade fever and malaise due to post-embolization syndrome
- Bladder spasm
- Infection at the catheter site
The most significant risk occurs if the particles are unintentionally delivered to arteries that supply nearby organs, such as the bladder or rectum, rather than the prostate. This can lead to tissue damage in those areas. Your doctor will discuss these risks with you and explain how to manage recovery at home to minimize complications.
PAE is a safe, minimally invasive option for many men living with urinary symptoms from an enlarged prostate. While results take time, the trade-off is fewer side effects and a quicker recovery.
If urinary symptoms are interfering with your comfort, talk with our specialists and learn if PAE may give you relief without surgery.
PAE FAQs
1. How does PAE compare with surgery in terms of effectiveness?
Surgery such as TURP often leads to greater and faster symptom improvement. However, it carries a higher risk of sexual side effects and requires a longer recovery. PAE generally provides meaningful relief for many men, with a quicker return to daily life. Many men experience lasting benefit for several years, though retreatment may be needed in some cases.
2. Can PAE be repeated if symptoms return?
Because the prostate continues to change over time, some men may develop symptoms again years later. In those cases, the procedure can be repeated or another treatment considered.
