How Does Prostate Artery Embolization (PAE) Work? What Patients Need to Know

We take a closer look at this alternative to TURP for patients dealing with enlarged prostate.

When most men are diagnosed with an enlarged prostate, they are typically given just one treatment option: TURP or transurethral resection of the prostate.

What they are not told is that they do not necessarily need to undergo prostate surgery. In fact, they can find relief from their symptoms with a safe, minimally-invasive procedure called prostate artery embolization (PAE).

How does prostate artery embolization work? Read on to learn more about this groundbreaking procedure.

How Does Prostate Artery Embolization Work?

PAE is a treatment that helps improve the symptoms of benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland. BPH usually affects men as they age, starting in the 40s and progressing with each decade. It is estimated that 90% of men over the age of 80 years have this condition.

By the time they reach 80 years of age, 90% of men will suffer from symptoms of enlarged prostate.

Instead of surgically cutting into the prostate gland, interventional radiologists can use vascular catheters to deliver tiny particles into the prostate gland’s blood vessels. The particles inhibit blood flow to the areas of the prostate most impacted by the enlargement, reducing the size of the prostate by causing the prostate to shrink.

The procedure can take up to three hours depending on the needs of the patient, such as the size and location of the arteries to be embolized.

Prostate Artery Embolization Technique

The doctor may start by inserting a catheter into an artery in the patient’s groin, feeding the catheter into the blood vessels that carry blood to the prostate gland.

With the catheter in place, the doctor will inject a dye into the blood vessels (called an arteriogram) to provide a map of the blood vessels that lead to the prostate.

Tiny microspheres are injected into the catheter to reach the necessary blood vessels, thereby reducing the supply of blood to the gland. Once one side of the gland has been treated, the doctor will treat the other side.

What are the advantages of Prostate Artery Embolisation Treatment?

Prostate Surgery Prostate Embolisation
Cuts, Stitches, Pain Yes No
Prostate Removed Preserved
Blood loss Yes No
Infection Chance Yes No
Rest after surgery 3-4 weeks Can resume work next day
Anesthesia Required Not required
Sexual side effects Yes No

What are Indications for P.A.E.?

As the prostate enlarges, it may partly block the urethra, causing symptoms such as:
⦁ Urinary incontinence, which can range from some leaking to complete loss of bladder control
⦁ Irritative voiding symptoms
⦁ Increased urinary frequency, urgency, and pain upon urination.

What are Contraindications for P.A.E.?

Patients are excluded from treatment if they have malignancy, renal insufficiency, bladder stones, a neurogenic bladder (a neurologic disorder that may affect bladder function), urethral stricture, an active urinary tract infection, or prostatitis.

Approx. Stay in hospital?

We have very fast and competent working team (Consultant, fellow, clinical assistant, technician and ward assistant) which provide you comfortable atmosphere and ease your nerves. Usual time of stay is around 1 day.


Minor complications include dysuria (9%), urinary tract infection (7.6%), microscopic hematuria (5.6%), acute urinary retention (2.5%), and rectal bleeding (2.5%)

Resume to work?

You can resume your work after 1 day if existing disease allows.


Cumulative rates of clinical success are 80- 85%.

What are the risks of Prostatic Artery Embolization?

PAE should only be performed by knowledgeable and trained interventional radiologists. Patients may experience “post-PAE syndrome” for days following the procedure, which can include nausea, vomiting, fever, pelvic pain, or painful or frequent urination.

Other risks include hematoma at the incision site; blood in the urine, semen, or stool; bladder spasm; or infection of the puncture site or prostate.

Next Steps

Here are some tips to help you get the most from a visit to your interventional radiologist:
⦁ Before your visit, write down questions you want answered.
⦁ Bring someone with you to help you ask questions and remember what your provider tells you.
⦁ At the visit, write down the names of treatments or tests, and any new instructions your provider gives you.
⦁ If you have a follow-up appointment, write down the date, time and purpose for that visit.
⦁ Know how you can contact your provider if you have questions