Prostatic Artery Embolization (PAE)

Prostatic artery embolization is a minimally invasive treatment designed for men experiencing moderate to severe urinary symptoms caused by an enlarged prostate, also known as benign prostatic hyperplasia (BPH). Instead of surgically removing prostate tissue, this advanced procedure reduces blood flow to the prostate, allowing it to shrink naturally over time. The result is improved urinary flow and relief from BPH symptoms, with less risk, discomfort and recovery time than traditional surgery.

50% of men over age 50 and 70% of men over age 60 suffer from an enlarged prostate (otherwise known as "BPH" or "Benign Prostatic Hyperplasia",) which can result in severe lower urinary tract symptoms and low quality of life.

Nainesh Parikh, MD, MBA

What does prostatic artery embolization involve?

During PAE, an interventional radiologist will insert a small catheter into the femoral artery in the groin. In some cases, the catheter may be inserted through the wrist instead. Using real-time imaging, the physician will carefully guide the catheter into the arteries that supply blood to the prostate. Once the catheter is in place, the physician will inject tiny medical-grade particles to block those arteries. The goal is to reduce blood flow to the prostate, which can cause the gland to shrink and relieve pressure on the urethra.

PAE is typically performed on an outpatient basis under mild sedation, often called twilight anesthesia. This will allow the patient to remain awake, relaxed and comfortable throughout the procedure, which usually takes approximately 1.5 to 2 hours to complete.

Who is a good candidate for prostatic artery embolization?

PAE may be an effective treatment option for a man with BPH who has not found adequate symptom relief with medication or prefers to avoid a more invasive surgical procedure.

Common symptoms of BPH include:

• Frequent or urgent need to urinate
• Difficulty starting urination
• Weak or interrupted urine stream
• Waking several times at night to urinate (nocturia)
• Incomplete bladder emptying
• Urinary leakage or dribbling
• Urinary retention or inability to urinate
• Recurrent urinary tract infections (UTIs)
• Dependence on a urinary catheter

To determine whether the patient is a good candidate for PAE, the physician will evaluate the size of the prostate, the severity of the symptoms, the patient’s overall health and other individual factors.

What are the benefits of prostatic artery embolization?

Compared to traditional surgical treatments for BPH, such as transurethral resection of the prostate (TURP) and prostatectomy, PAE offers several potential advantages. These include:

• Minimally invasive technique – No surgical incision or general anesthesia is required.
• Shorter recovery time – Most patients can resume their daily activities within a few days.
• Lower risk of complications – PAE is less likely to cause excessive bleeding, infection and urinary incontinence.
• Preservation of sexual function – PAE is associated with a lower risk of retrograde ejaculation and erectile dysfunction.
• Long-lasting relief – Many men experience sustained improvement in urinary symptoms for several years after treatment.

How to prepare for prostatic artery embolization

The interventional radiologist will provide the patient with detailed instructions on how to prepare for PAE, which may include:

• Undergoing blood work and imaging studies to allow the physician to assess the prostate and surrounding vessels
• Adjusting or pausing certain medications, such as blood thinners, which can interfere with anesthesia or healing
• Fasting for several hours before the procedure
• Arranging for someone to drive them home afterward

After reviewing the patient’s medical history, the physician will fully explain what the patient can expect before, during and after treatment.

What to expect after prostatic artery embolization

After undergoing PAE, the patient will rest briefly in a recovery area before being discharged home the same day. Post-procedure expectations may include:

• Mild pelvic discomfort, burning during urination and/or frequent urination for several days
• Symptom improvement within two to four weeks
• Resumption of normal activities within a few days

The interventional radiologist will schedule follow-up appointments—typically at six and 12 weeks—to monitor the patient’s recovery and symptom improvement.

What are the risks and potential complications of prostatic artery embolization?

As with any medical procedure, PAE carries some risks, although most are typically mild and temporary. These include:

• Minor bruising or pain at the catheter site
• Temporary urinary frequency or discomfort
• Blood in the urine or semen for a few days
• Infection or allergic reaction (rare)
• Accidental blockage of nearby vessels (non-target embolization, also rare)

Before the procedure, the physician will explain all potential risks and ensure PAE is an appropriate treatment option for the patient’s specific situation.

Benefit from world-class care at Moffitt Cancer Center

Moffitt is among a select few high-volume centers in the United States offering prostatic artery embolization. Our team combines advanced imaging technology with world-renowned expertise in interventional radiology to deliver precise, personalized care. We are also conducting ongoing clinical research to explore the benefits of PAE for patients diagnosed with both BPH and prostate cancer—making Moffitt one of the only cancer centers in the world studying this therapy under Institutional Review Board-approved protocols.

Take your first step toward finding relief from your BPH symptoms. Request an appointment with a specialist at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.