Prostatic Artery Embolization

Medically reviewed by Dr. Bhavesh Arun Popat, a vascular & interventional radiologist.
Updated on 21st March 2025

Prostatic Artery Embolization (PAE) is a cutting-edge minimally invasive treatment developed in Europe that aids in the relief of lower urinary tract symptoms of Benign Prostatic Hyperplasia (BPH).

  • An interventional radiologist performs PAE by using X-rays and other advanced imaging technology to see inside the body and treat the condition without surgery.
  • A small catheter is inserted by your interventional radiologist into the artery in your wrist or groin.
  • The interventional radiologist then guide the catheter into the vessels that supply blood to your prostate. Without damaging any tissue, tiny round microspheres (particles) are injected through the catheter and into the blood vessels that feed your prostate to reduce its blood supply.
  • As the blood supply to the prostate reduces, it shrinks in size thus releasing pressure from the urethra leading to relief for the patient.

Benefits of PAE

A minimally invasive & non-surgical option, PAE for men with Benign Prostatic Hyperplasia (enlarged prostate). PAE does not require hospital stay, has faster recovery and fewer side effects are observed as compared to traditional surgery. Also, with prostatic artery embolization there is no limits on the size of the prostate.

Benefits of PAE include: -

  • Done mostly as an outpatient procedure
  • No or minimal hospital stay and a fast shorter recovery time
  • Local Anesthesia only
  • Lower risk of sexual side effects or incontinence as compared to traditional surgery.
  • No direct tissue damage in the form of resection or enucleation
  • Nearly no blood loss
  • Slight pain and swelling
  • In most cases catheter use is minimised
  • No limits on prostate size, urethral narrowing, or bladder capacity
  • Safe for patients with co-morbidities, though certain protocol-induced exclusions are advised. Discuss your eligibility with an interventional radiologist
  • The risk of side effects like sexual dysfunction, heavy bleeding, and urinary tract infections is less than 1% of major complications and 1-3% of minor complications
  • Insurance recognized

Significant research has been done in the past 15 years on Prostatic Artery Embolisation making the procedure and technique safe and reliable for patients and doctors. It is trusted by doctors globally.

What, if any, are the risks associated with prostate artery embolization?

Prostate Artery Embolisation (PAE) is considered a very safe procedure. But it is to be noted that it is a medical procedure and like any medical treatment there can be some risks and complications and a patient should be aware of the same.

According to the World Journal of Urology, “some people may experience some side effects such as rectal bleeding, acute urinary retention and transient blood in the urine. Some men may experience a slight burning sensation in the pelvis for a few days following the procedure. Blockage of other blood vessels outside of the prostate gland is a small possibility.”

PAE is safer and more effective when performed by experienced professionals such as the team at Endovascular clinic.

Is Prostatic Artery Embolisation is right for you?

The PAE procedure is safe and minimally invasive. It has proven advantage over traditional surgeries. However since it is relatively new technology as compared to surgeries not all medical fraternity has experienced the benefits and improvement in patient outcomes. This procedure is even recommended and considered safe for patients who are ineligible for surgery.

For a conclusive recommendation if the PAE procedure is right for you, you should get an opinion from interventional radiologist doctor who performs PAE.

You may be a candidate for prostate artery embolization if you have:

  • Tried medication for six months or more without relief from symptoms
  • If the medication caused significant side effects
  • You are looking for non-surgical options for your treatment
  • You intend to preserve your sexual function Discuss with your doctor
  • Ask your doctor about the side effects and risks associated with conventional surgical options
  • Consult an Interventional Radiologist

What are the advantages of Prostate Artery Embolization (PAE) over Transurethral resection of the prostate (TURP)?

PAE like TURP improves urinary tract symptoms. Both are recognised treatment options fpr enlarged prostate. PAE is performed by an interventional radiologist while a TURP is performed by an urologist.

However, PAE has some advantages vs. TURP, including:

  • Faster recovery time without hospitalization
  • Lower risk of complications
  • Fewer or minor complications
  • TURP has significant side effects
  • PAE in many cases, can even be performed on patients who are ineligible for TURP procedure.

Which doctors to consult?

Anatomically, BPH is a urological medical condition and hence traditionally a Urologist is the primary doctor for the medical condition. However, the new treatment option like PAE is performed by an interventional radiologist. It is particularly important for the patient that the procedure is done by an experienced doctor with special training in PAE. This is a critical factor to lower risks. Our advice would be that once you have been diagnosed with the condition consult both a urologist and interventional radiologist for an optimum treatment plan.

Prostatic Artery Embolisation is among the approved treatment option for BPH in the guidelines issued by

What Bench Mark Institutions Says About PAE Procedure

  • The PAE procedure has a lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction) when compared with more invasive surgical procedures such as transurethral resection of the prostate (TURP). - - Johns Hopkins Medicine
  • Prostatic artery embolization was a safe and effective procedure for benign prostatic hyperplasia with good long-term results for lower urinary tract symptoms. - -Radiology Society of North America
  • 10-year study conclusion Prostate artery embolisation is a promising option for treating lower urinary tract symptoms in men with benign prostatic hypertrophy. Proper patient selection and thorough evaluation is critical to ensure clinical success. Many studies have shown clinical results that are comparable to the current surgical gold standard, TURP. The use of PAE offers equivalent results with fewer complications and fewer side effects while eliminating the need for general anesthesia or hospitalisation. - - National Institute of Health - USA 2021 study
  • In clinical studies, this procedure (PAE) has demonstrated excellent outcomes with minimal risk and quick recovery times. - - Cedars-Sinai Medical Center
  • This procedure works well for lower urinary tract symptoms caused by benign prostatic hyperplasia, and there are no serious concerns about its safety. Benefit is that compared to other surgical options it has fewer complications. - - National Institute of Health & Care Excellence, UK

What to expect after PAE Procedure?

You can eat and drink your usual meals and restart all your medications. It is normal to:

  • Have a small amount of blood in your urine for 1 to 2 days
  • Feel burning when you urinate for the first 3 to 5 days (this is not an infection)
  • Urinate (pee) more frequently
  • Have a mild fever 3 to 5 days after the procedure
  • Feel tired for 1 week
  • Have mild nausea and vomiting
  • Have mild pelvic pain and bladder spasms
  • Have small bruising at the puncture site
  • Patients are discharged from the hospital on the same day but are advised to rest on the first day

FAQ's

What happens during a PAE procedure?

  • Once patient is taken in the procedure room and prepared for the procedure, local ananesthesia is applied to numb your wrist or groin area.
  • After that, a needle is inserted to assist in the placement of a catheter, led by an X-ray technique called fluoroscopy to access the blood vessels supplying the prostate.
  • After that, an arteriogram is done by introducing a contrast dye to visualize the blood supply to the prostate. With the visualisation of artery clear, a synthetic embolic agent, resembling grains of sand, will be injected through the catheter.
  • These will block the blood flow to the prostate vessels, so it is starved of its blood supply. The procedure is continued for few more minutes till complete blood flow obstruction is achieved.
  • The catheter will then be repositioned on the opposite side of the prostate, and the process is repeated. During the procedure, patient will lie on comfortably on his back and will be awake throughout the procedure.
  • Typically the procedure completed in under an hour, than the patient is shifted to private room for recovery.

How long does the PAE procedure take?

Time taken to perform the procedure varies and depends on the severity of the condition. Mostly the duration of a prostate artery embolization or PAE is around one to one and half hours. Patients are able to go home the same day. Recovery is fast and only takes a few days before patients can go about their normal routine and return to work.

How long does a patient need to stay in the hospital?

Patients will need to stay in the hospital for one day for the prostate artery embolization procedure.

Do I need to stay fasting for the PAE procedure?

Yes. Similar to any other medical procedure involving intervention and anesthesia, patients do need to stay fasting for 6 hours before the procedure.

Does PAE hurt?

No. Prostatic Artery Embolisation / PAE does not cause pain to the patients, and hence patients are not administered general anesthetic. Local anaesthesia  is applied at the location from where the catheter is inserted which is away from the actual prostate location. Post the procedure is completed, the catheter is withdrawn. Patient may feel a warm sensation when the beads are injected but no pain. In certain patients, if patients are too anxious sedative may be administered by the clinicians.

Will PAE cause incontinence?

Incontinence is a common possible side effect of TURP. TURP is a surgery which requires inserting a resectoscope into the tip of the penis. PAE is not established to cause incontinence.

Is PAE performed through the penis?

No. Nothing goes in or via your penis. PAE is performed inside arteries. For which catheter is inserted either via wrists or thigh/groin.

What is the PAE success rate?

Prostate artery embolization has a very high success rate. About 95% of the patients enjoy symptomatic relief. After the procedure, patients can once again enjoy a normal, relaxed life. Approximately six months after PAE, the prostate normally reduces in size by about 40%. This reduction allows the urethra to decongest or open up and urine flows more normally. Prostate size shrinkage via PAE does not harm sexual function.

PAE remains the first choice of treatment for its benefits. Also if for any clinical reason, the procedure doesn´t provide relief, the patient can still opt for surgical options. However vice versa is not possible.

Will PAE in any way affect my ability to have children?

No. PAE does not affect fertility. Rather it has been reported that some men experience improvement in their sexual performance.

Does insurance cover prostate artery embolization?

Yes. Most insurance carriers cover PAE. Please check with your insurance provider to see if your specific plan covers the procedure. Our team at the endovascular clinic will be happy to help you with your Mediclaim.

What is prostate artery embolization (PAE)?

Prostate artery embolization (PAE) is a non-surgical minimally invasive procedure for treating prostate enlargement. Tiny/ Very small microspheres are injected into the blood vessels (arteries) which supply to the prostate gland. These microspheres block off the blood flow causing the swelling in the prostate glad thus reducing the size of prostate.