Procedure
Prostatic Artery Embolization (PAE)
PAE is a minimally invasive, outpatient treatment for men whose lower urinary tract symptoms from benign prostatic hyperplasia (BPH) — frequent urination, weak stream, urgency, nighttime trips to the bathroom, incomplete emptying — are not adequately controlled with medication and who want to avoid traditional surgery.
How it works
An enlarged prostate compresses the urethra and obstructs urine flow. PAE delivers tiny embolic particles through the small arteries that feed the prostate, reducing its blood supply. Over the following weeks the prostate gradually shrinks and softens, which relieves the obstruction and improves urinary symptoms without cutting, burning, or removing prostate tissue.
Who benefits
- Bothersome BPH symptoms despite medical therapy
- Men who want to avoid TURP, prostatectomy, or other surgical options
- Patients with very large prostates that may be challenging for some surgical techniques
- Men who prioritize preservation of sexual function — ejaculation and erection
- Patients on blood thinners or with comorbidities that increase surgical risk
What to expect
- Outpatient procedure under local anesthesia only. No sedation, no general anesthesia.
- Pinhole access through the wrist (radial-first) or groin.
- Detailed angiographic mapping of the prostatic arteries on both sides.
- Selective embolization of both prostatic arteries to reduce gland blood supply.
- Procedure duration: typically 1.5–3 hours depending on anatomy.
Recovery
Most men go home the same day without a urinary catheter. Mild pelvic discomfort, a low-grade fever, or some urinary urgency for a few days is common and self-limited. Return to desk work in 2–3 days. Urinary symptoms typically begin improving within 2–4 weeks, with maximal benefit at 3–6 months as the gland shrinks.
Why this matters
Unlike many surgical options for BPH, PAE carries minimal risk of urinary incontinence and rarely affects ejaculation or erections. There is no resected tissue, no urethral instrumentation, and no general anesthesia. For the right patient, it offers durable symptom relief with a fraction of the recovery.
