Prostatic Artery Embolization

As men age, it’s common for the prostate gland surrounding the urethra to grow bigger.

For some, this growth, called benign prostatic hypertrophy (BPH), becomes more than just a normal part of aging. It starts to interfere with daily life. Frequent urges to urinate, waking up multiple times at night, and a weak urine stream are often signs of BPH. Unfortunately, these symptoms can gradually worsen if left untreated.

If medications aren’t providing enough relief or are causing unwanted side effects, you may be looking for a safer, less invasive option to surgery.

Prostatic artery embolization (PAE) offers an effective treatment alternative for men with moderate to severe BPH symptoms.

PAE is a minimally invasive outpatient procedure that shrinks the prostate by reducing its blood supply. Without a steady blood supply, the prostate tissue gradually shrinks. This reduces pressure on the urethra and eases symptoms.

The doctor makes a small cut, often in the groin or wrist. Then, they insert a catheter into the blood vessels. The catheter is carefully advanced to the arteries that feed the prostate. Tiny round particles called microspheres are released in the vessels, which block them.

Because there are no incisions in the prostate itself, recovery is typically much quicker than traditional surgical procedures.

Many men find relief from the most frustrating urinary symptoms caused by BPH, including:

• A frequent or urgent need to urinate
• Trouble starting urination
• A feeling of incomplete bladder emptying
• Waking often at night to urinate, called nocturia
• A weak or interrupted urine stream
• Unexpected leaks or dribbling

It’s important to note that results aren’t immediate. The prostate shrinks over time, so improvements usually begin within a few weeks. Maximum relief is typically reached three to six months after the procedure.

Before

You’ll meet with your doctor for an evaluation. Imaging procedures, such as a pelvic CT scan or MRI, may be performed. This is used to examine the arteries around your prostate and make sure they’re suitable for embolization. They will also review your health history and medications.

During

On the day of PAE, sedation is used to help you relax. General anesthesia is not required.

PAE is performed by an interventional radiologist. The doctor inserts a catheter through a tiny skin puncture and uses real-time X-ray guidance to access the prostate arteries. Once in position, the doctor slowly injects embolic agents into these arteries. These particles block blood flow to specific areas of the prostate, causing it to shrink over time. The entire procedure typically takes just under two hours.

After

Following the procedure, you’ll stay in a recovery area for a few hours. Most men go home the same day. It’s normal to experience some pelvic cramping, burning with urination, or mild fatigue for a few days. These effects tend to resolve quickly. Recovery is generally easy, and most men return to their normal activities within a few days. Strenuous activity should be avoided for about a week.

PAE may be a good fit for you if:

• You’re experiencing moderate to severe urinary symptoms due to BPH
• You want to avoid surgery or long-term medication use
• You’ve had side effects from BPH medications
• You’re not a candidate for surgery due to other health conditions
• Preserving sexual function is important to you

Some men with very large prostates or complex artery anatomy may not be ideal candidates. This is why imaging before the procedure is an important step.

PAE offers several unique advantages compared to medications or traditional surgical options like transurethral resection of the prostate (TURP):

• No incisions in the prostate means a lower risk of complications
• Lower risk of retrograde ejaculation or erectile dysfunction
• Shorter recovery time
• Outpatient procedure
• Sustained relief with symptom improvement lasting several years

Prostatic artery embolization has some risks, like any procedure, though they are generally low. These may include:

• Mild pain, burning, or cramping in the days after the procedure
• Temporary difficulty urinating or incomplete bladder emptying
• Blood in the urine or semen for a few days
• Infection at the catheter site

Rarely, unintended blockage of nearby blood vessels may occur. Your doctor will review all potential risks and provide you with aftercare instructions to help you recover smoothly.

If urinary symptoms keep you up at night, interfere with work, or affect your daily routine, it’s time to talk to a specialist. Even if you’ve tried medications or other treatments in the past, PAE may offer a more permanent solution.

1. Will I need a catheter after the procedure?

In most cases, no. However, some men may need a temporary catheter if there’s swelling that makes urination difficult immediately afterward.

2. How long does it take to feel better?

Some men begin to notice relief in a few weeks, but the full benefit typically develops over three to six months.

3. Does PAE affect sexual function?

Most men do not experience sexual side effects. PAE has a lower risk of retrograde ejaculation or erectile dysfunction compared to other surgical options.

All of our providers treat BPH.