A Patient Guide to Prostate Artery Embolization (PAE)

June 23, 2026 Trimark Digital

In this blog:

• Prostate artery embolization (PAE) is a minimally invasive outpatient treatment that shrinks and softens an enlarged prostate by reducing its blood supply.
• PAE improves urinary symptoms caused by benign prostatic hyperplasia (BPH), including frequent urination, urgency, weak stream and incomplete bladder emptying.
• Unlike traditional surgical procedures such as TURP, PAE does not involve removing prostate tissue or operating through the urethra.
• Patients return home the same day and resume normal activities within a few days.
• Studies demonstrate durable symptom relief lasting years.

If you’re waking up three or four times a night to urinate, struggling with a weak stream or planning your day around bathroom access, you’re not alone. These symptoms are often caused by benign prostatic hyperplasia (BPH), also known as an enlarged prostate. BPH affects millions of men as they age and can have a significant impact on sleep, travel, work and overall quality of life.

Many men assume surgery is the only effective treatment option. While procedures such as TURP and HoLEP can be highly effective, they are not the only option. At Richmond Vascular Center, we offer Prostate Artery Embolization (PAE), a minimally invasive outpatient procedure that provides meaningful symptom relief without surgery, without a hospital stay and without operating through the penis.

What Is Prostate Artery Embolization (PAE)?

The prostate is a gland that sits below the bladder and surrounds the urethra, the tube that carries urine out of the body. As the prostate enlarges with age, it compresses the urethra, making urination increasingly difficult.

Symptoms of BPH are referred to as LUTS or Lower Urinary Tract Symptoms:

• Frequent urination
• Urgency
• Waking at night to urinate (nocturia)
• Dribbling and incontinence
• Weak urinary stream
• Hesitancy or straining to urinate
• Incomplete bladder emptying

Over time, severe obstruction can contribute to urinary retention, recurrent urinary tract infections, bladder stones, and, in some cases, kidney dysfunction.

PAE is a minimally invasive treatment designed to shrink and soften the enlarged portions of the prostate. During the procedure, tiny particles are delivered into the arteries supplying blood to the prostate, reducing its blood flow and causing the gland to gradually decrease in size and become less firm. With these changes to the prostate, pressure on the urethra decreases and urinary symptoms often improve significantly. One of the reasons many men are attracted to PAE is that it treats the prostate without removing tissue, without surgical incisions and without instruments passing through the penis or urethra.

How Does the PAE Procedure Work?

PAE is performed by an interventional radiologist, a physician specially trained in image-guided minimally invasive procedures. At Richmond Vascular Center, the procedure is performed in our outpatient center using advanced imaging technology to carefully identify the arteries supplying the prostate while protecting surrounding structures.

A typical procedure includes:

Preparation

Patients receive local anesthetic at the access site in the upper thigh as well as light sedation to keep them comfortable. Most patients remain awake but relaxed throughout the procedure.

Access

A skin nick is made in the upper thigh to access the femoral artery.

Guidance

Using real-time imaging, a thin catheter is navigated through the arteries to the blood vessels supplying the prostate.

Embolization

Microscopic particles are delivered into the targeted arteries, reducing blood flow to the enlarged prostate tissue.

Completion

The catheter is removed from the artery and a small bandage is applied. No stitches are required. Patients recover for an hour and then return home.

PAE vs TURP: Why Are More Men Considering PAE?

TURP (Transurethral Resection of the Prostate) has long been considered a standard treatment for BPH. TURP works by surgically removing prostate tissue through the urethra. For many men, however, the idea of surgery, hospitalization, anesthesia or potential sexual side effects leads them to explore alternatives.

Comparing PAE and TURP

PAE Success Rates: Does It Work?

The short answer is yes.

Multiple high-quality studies have demonstrated significant improvements in urinary symptoms, quality of life, urinary flow rates and prostate volume following PAE. These benefits can last for several years after treatment.

Patients commonly experience:

• Reduced urinary frequency
• Less urgency
• Fewer nighttime bathroom trips
• Improved urinary flow
• Better bladder emptying
• Improved quality of life

How Much Does the Prostate Shrink?

While results vary from patient to patient, studies have demonstrated average prostate volume reductions of approximately 30 percent to 40 percent following PAE. Symptom improvement is not just from volume reduction, but also a softening of the gland following embolization.

How Long Does PAE Last?

PAE provides durable symptom relief for most patients. The prostate remains a living gland and can continue to grow slowly over time as part of the natural aging process. Some men may eventually require additional treatment years later, but most continue to experience significant symptom improvement long after their procedure.

Repeat PAE remains an option in selected patients if bothersome symptoms recur.

What To Expect After PAE

Recovery

Because PAE is performed through a skin nick, recovery is typically quick and straightforward.
Patients spend about an hour in our recovery area before returning home the same day.

Most patients resume normal light activities within one to two days. Heavy lifting and strenuous exercise are generally avoided for about one week.

Symptom improvement often begins within a few weeks and continues to progress for several months as the prostate responds to the treatment.

Side Effects

Most side effects are temporary and resolve on their own.

Patients may experience:

• Mild pelvic discomfort or pressure
• Increased urinary frequency or urgency for a short period
• Burning with urination
• Small amounts of blood in the urine, semen or stool
• Flu-like symptoms for a day or two

Serious complications are uncommon when the procedure is performed by experienced physicians.

Are You a Candidate for PAE?

PAE may be an excellent option if:

• You have been diagnosed with BPH and experience bothersome urinary symptoms.
• Medications are no longer providing adequate relief.
• You wish to avoid surgery.
• You are concerned about recovery time or sexual side effects.
• You have a large prostate.
• You have medical conditions that increase surgical risk.
• You have been told you may need TURP, HoLEP or another prostate procedure and want to understand all of your options.

The best way to determine whether PAE is right for you is through a consultation and imaging review with an experienced interventional radiologist.

Understand All of Your Treatment Options

Every patient is different, and there is no single best treatment for every man with BPH.

Our goal at Richmond Vascular Center is not to replace surgery. It is to ensure patients understand all of their options before making a decision.

For the right patient, PAE can provide meaningful, long-lasting symptom relief without surgery, without a hospital stay and with a recovery measured in days rather than weeks.

If urinary symptoms are affecting your sleep, travel, work or quality of life, schedule a consultation to learn whether PAE may be right for you.