Home / Procedures / Prostate Artery Embolization
Procedure · Men's Health · Urology

Prostate Artery Embolization

A minimally invasive alternative to prostate surgery for men with enlarged prostate (BPH) symptoms — frequent urination, weak stream, getting up multiple times at night. PAE shrinks the prostate by reducing its blood supply, with no incision, no catheter to take home, and no sexual side effects.

Procedure type: Image-guided, minimally invasive
Time at office: ~2 hours
Recovery: 1–3 days
Performed by: Board-certified IR
~2 hrs
Total time at our office, outpatient procedure
No
Catheter to take home, no sexual side effects
~85%
Of patients in published studies report symptom improvement
4–6 wks
Typical timeline to feel the full benefit
What it is

A different way to treat an enlarged prostate.

Anatomical diagram of the prostate and bladder showing prostate arteries targeted in PAE procedure Medical illustration for Valley Joint Pain Center patient education. bladder prostate prostate arteries

Fig. 01PAE targets the prostate arteries (the small vessels supplying blood to the prostate) and reduces their flow with microscopic particles. Without its full blood supply, the prostate shrinks over the following weeks.

Benign prostatic hyperplasia (BPH) — non-cancerous prostate enlargement — affects roughly half of men by age 60 and 80% by age 80. As the prostate enlarges, it squeezes the urethra and causes the symptoms many men know all too well: frequent urination, urgency, weak stream, incomplete emptying, and getting up multiple times at night.

The traditional treatments are medications (which often cause side effects and stop working over time) or surgery (TURP, UroLift, Rezūm) — each with its own trade-offs around recovery, sexual function, and how aggressive the intervention needs to be. Prostate Artery Embolization (PAE) is a different option that fits in between.

PAE works by reducing the blood supply to the prostate. Through a fine catheter introduced through the wrist or upper thigh, microscopic particles are delivered into the small arteries feeding the prostate. The prostate then gradually shrinks over the following weeks as those vessels are reduced — relieving pressure on the urethra and improving urinary symptoms. There's no incision, no general anesthesia, no catheter to take home, and the procedure is done at major academic medical centers across the country.

Candidacy

Who PAE works for, and who is better served by other options.

PAE has expanded considerably as an option in recent years, but it isn't right for every man with BPH. Some patients are better served by medications first; others by surgery. Here's the honest read on candidacy.

Often a good fit

  • Moderate to severe BPH symptoms that affect daily life or sleep
  • Prostate enlargement confirmed on imaging or examination
  • Medications have failed, caused intolerable side effects, or stopped working
  • You want to avoid TURP or other surgery, especially if concerned about sexual side effects
  • You're a poor surgical candidate due to other health conditions (heart disease, anticoagulation, etc.)
  • You have a particularly large prostate (>80g) that may not be a good fit for some other procedures

Probably not the right procedure

  • Acute urinary retention requiring immediate surgical relief
  • Confirmed prostate cancer requiring oncologic treatment
  • Severe peripheral artery disease that complicates catheter access
  • Symptoms not actually caused by prostate enlargement (urethral stricture, neurogenic bladder)
  • Untreated bladder dysfunction independent of prostate size
  • You're a strong candidate for and prefer surgical options like TURP or UroLift
A different procedure, the same approach

PAE uses the same precision technique we use for joint pain.

Embolization is the underlying skill — selectively closing off the blood supply to a specific area to address a specific problem. The technique is the same whether we're treating a knee, a prostate, or a uterus. What differs is the anatomy, the indications, and the evidence base for each application.

Read about Dr. Dhand's embolization training →

PAE isn't the right answer for every man with BPH, and we're honest about that. But for the man who's on three medications that aren't working, who isn't a great surgical candidate, or who genuinely wants to avoid the sexual side effects of surgery — PAE is a real option that wasn't available a decade ago. The conversation worth having is whether you're that patient.

Dr. Sabeen Dhand · Board-Certified Interventional Radiologist
Frequently asked

What patients usually want to know.

Yes. Medicare covers PAE, as do many commercial insurance plans. Coverage typically requires documentation of failed medical therapy or contraindications to surgery. We verify your benefits before scheduling and provide written cost estimates in advance.
This is one of PAE's major advantages. Unlike TURP and some other prostate procedures, PAE has not been associated with increased rates of erectile dysfunction, retrograde ejaculation, or other sexual side effects in published studies. For many men, this is the deciding factor.
TURP physically removes prostate tissue through the urethra. UroLift uses small implants to mechanically hold the prostate aside. Rezūm uses water vapor to ablate prostate tissue. PAE doesn't physically alter the prostate at all — it reduces the blood supply, allowing the prostate to gradually shrink on its own. Each procedure has different recovery profiles and trade-offs; we'll discuss which makes most sense for your specific anatomy and preferences.
Some men notice improvement within 1–2 weeks, but the full benefit typically develops over 4–6 weeks as the prostate gradually shrinks. We follow up at 1 week, 1 month, and 3 months to track your symptom improvement objectively.
No. Unlike most prostate surgeries, PAE doesn't require a Foley catheter to take home. You'll urinate normally before discharge.
Medications like tamsulosin, finasteride, and tadalafil work for many men but require daily use, often have side effects (dizziness, low blood pressure, sexual side effects), and frequently lose effectiveness over time. PAE is a one-time procedure with durable results — most patients no longer need daily BPH medications afterward.
Most men return to normal activity within 1–3 days. There's mild groin or wrist soreness at the catheter site (usually resolves within a week), and a small percentage of patients experience temporary urinary symptoms in the first 1–2 weeks as the prostate begins to shrink. Most men are back to work within 2–3 days.

Wondering if PAE could be right for you?

Our brief assessment helps you understand whether you're likely to be a candidate. If you are, we'll invite you in to discuss your specific situation with Dr. Dhand.

Take the 2-minute assessment

No commitment · No insurance required to assess