Benign prostatic hyperplasia (BPH) is the enlargement of the prostate gland that affects men as they age. The growing prostate squeezes the urethra (urine tube) and makes it harder for urine to flow. Prostate Artery Embolization is a non surgical treatment for BPH. Watch the video to see how an enlarged prostate can affect urination and how Prostate Artery Embolization can treat it.
Most Common symptoms include:
These are called lower urinary tract symptoms (LUTS) from BPH.
Prostate Artery Embolization is a minimally invasive, non-surgical procedure performed by an interventional radiologist to treat BPH. Through a tiny catheter in an artery, the doctor blocks the small blood vessels that feed the prostate, essentially coming off the blood supply to the prostate, causing it to shrink which relieves the urinary symptoms.
By reducing blood flow, the prostate gradually shrinks over weeks to months. As the prostate gets smaller, pressure on the urethra decreases, so urine flows more easily and symptoms such as frequency, urgency, and nighttime urination improve. Watch the video to see how PAE works.
Good candidates typically are men who:
Evaluation usually includes symptom questionnaires, labs, and imaging (such as MRI or Ultrasound).
Yes. Multiple studies and a multisociety position statement (Society of Interventional Radiology and American urological Association) support PAE as a safe, effective option for appropriately selected patients who want to avoid surgery or long-term medications.
Yes. PAE is often considered for men who are high-risk for anesthesia, have significant medical conditions, are on blood thinners, or have very large prostates where standard surgery is more difficult. It can provide symptom relief in many men who are not ideal candidates for TURP or laser procedures.
Many studies show that PAE can help men who are dependent on a urinary catheter due to BPH. A significant proportion of catheter-dependent patients are able to come off the catheter after PAE, once the prostate shrinks and obstruction improves.
PAE may not be appropriate for men who:
Your interventional radiologist and urologist will review your imaging and medical history to decide if PAE is right for you.
An interventional radiologist guides a thin catheter from an artery in the wrist or groin into the small arteries that supply the prostate. Tiny particles are injected to reduce blood flow to the prostate on both sides. The procedure is done using live X-ray guidance in an outpatient angiography suite. Watch a video to see how PAE is performed.
PAE is usually performed with local anesthetic at the catheter entry site and moderate or deep sedation through an IV. You are sleepy and relaxed but breathing on your own, avoiding the need for general anesthesia in most patients.
Most PAE procedures take about 1 to 2 hours, depending on your anatomy and how easy it is to reach the prostate arteries. You will also spend some time in recovery afterward, and will go home the same day.
The catheter is most commonly inserted through a small puncture in the wrist (radial artery) or groin (femoral artery). The puncture site is only a few millimeters wide and does not require stitches or produce scars.
Tiny medical-grade particles (microspheres) are injected into the prostate arteries. These inert particles are designed to safely lodge in the small vessels, reduce blood flow, and trigger gradual shrinkage of the prostate tissue.
Systematic reviews and randomized trials report significant improvement in symptom scores, quality of life, and urine flow in most men after PAE, with response rates typically around 80%.
Some men notice better flow and less urgency within days to weeks, while for others improvement is gradual over 1–3 months as the prostate shrinks.
Studies following patients for 3–10 years show that most men maintain meaningful symptom relief, although some may need repeat treatment or other procedures over time.
Yes. If symptoms return and imaging shows regrowth or new blood supply, PAE can often be safely repeated, or other BPH treatments can be considered based on your goals, clinical symptoms and anatomy.
Key advantages of PAE include:
Most side effects are mild and temporary, such as pelvic discomfort, urinary frequency, burning with urination, or small amounts of blood in the urine or semen. Rare but more serious risks include non-target embolization (blocking the wrong artery), infection, or damage to blood vessels, which are uncommon in experienced centers.
Randomized trials and large registries show lower rates of major complications with PAE compared to TURP, especially regarding bleeding, need for transfusion, and hospital length of stay. Overall, PAE has a much favorable safety profile compared to surgery when performed by experienced interventional radiologists.
Most studies show significantly low rates of erectile dysfunction and retrograde ejaculation with PAE compared with TURP and some laser procedures. Many men report stable or even improved sexual satisfaction as urinary symptoms improve.
Patient go home the same day. Many men feel well enough for light activities within 1–3 days and experience mild pelvic or urinary discomfort for up to a week, managed with oral medications.
You can usually return to desk work and gentle activities within a few days and gradually resume exercise over 1–2 weeks, based on how you feel and your doctor’s advice. Heavy lifting should be avoided for several days to protect the artery puncture site.
All of these are less invasive than open surgery, but they differ in how they work, anesthesia needs, and long-term data. PAE is particularly attractive for men with larger prostates or higher surgical risk, with data suggesting comparable symptom relief and good sexual function preservation for many patients.
Large single-center series and meta-analyses show durable improvement in symptoms and quality of life for most men, with clinical success in roughly 70–80% at 3–5 years and acceptable retreatment rates.
Some men may experience gradual return of symptoms over several years due to ongoing aging and prostate changes. If this happens, options include repeat PAE, medications, or other procedures depending on your situation.
Yes. Many centers safely perform repeat PAE when symptoms recur and imaging confirms the need; outcomes are generally good, although data are more limited than for first-time PAE.
On average, studies report 20–40% reduction in prostate volume over 6–12 months, though the exact amount varies from person to person. Even moderate shrinkage can lead to large improvements in symptoms and quality of life.
Insurance coverage is improving as more evidence supports PAE. Many commercial insurers and some health systems now cover PAE; Medicare coverage is region-dependent. Our team at Florida Interventional Institute can check your specific plan and obtain pre-authorization when needed.
Before PAE, you will typically:
Our staff will provide a clear checklist tailored to you.
In many cases, a referral from your primary care doctor or urologist is helpful and may be required by insurance, but some patients can self-refer. We work closely with your other doctors to ensure coordinated, comprehensive BPH care.
Clinical Practice Guidelines & Consensus Statements
Cochrane Review & Systematic Reviews/Meta-Analyses
Randomized Controlled Trials
Large Cohort Studies & Registries
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