Prostate artery embolization (PAE) in Atlanta
A minimally invasive, catheter-based treatment for an enlarged prostate. PAE blocks blood flow to parts of the prostate so it shrinks, easing pressure on the urethra without cutting or removing prostate tissue.
Medically reviewed by Dr. Chirag Dave
Key facts
- Treats urinary symptoms caused by benign prostatic hyperplasia (BPH).
- Done through a small puncture in an artery in the wrist or upper thigh, not through the urethra.
- Tiny particles reduce blood flow to parts of the prostate, which shrinks over time.
- Performed by an interventional radiologist working with Advanced Urology, in an outpatient setting.
- Symptom changes develop gradually over weeks to months.
What is prostate artery embolization?
The prostate is a walnut-sized gland that surrounds the urethra, the tube that carries urine out of the body. With BPH the prostate grows larger and can press on the urethra, causing a weak stream, frequent urination day and night, urgency and a feeling that the bladder does not fully empty.
Prostate artery embolization (also called prostatic artery embolization or PAE) treats this by reducing the prostate's blood supply. A thin, flexible tube called a catheter is guided through the arteries to the small vessels that feed the prostate. Microscopic beads, known as microspheres, are released through the catheter to partly block those vessels. With less blood flow, the treated parts of the prostate shrink, which can relieve pressure on the urethra.
Who is a candidate for prostate artery embolization?
PAE is one of several options for BPH. It is often considered for men who:
- Have bothersome urinary symptoms from an enlarged prostate.
- Have not had enough relief from BPH medication, or have side effects from it.
- Have a larger prostate.
- Prefer to avoid surgery or a procedure done through the urethra.
PAE may not be suitable for everyone. Blood vessel anatomy, kidney function, prior pelvic procedures, bladder problems and suspected prostate cancer all affect the decision. An evaluation, including imaging, helps your care team decide whether PAE or another treatment fits you.
How PAE compares with other BPH treatments
Each option works differently, and the right choice depends on your prostate size and shape, your symptoms, your overall health and your priorities. This is a general overview, not a ranking.
| Option | How it works | What it involves |
|---|---|---|
| Medication | Alpha blockers relax muscle at the bladder neck; 5-alpha reductase inhibitors shrink the prostate. | A daily prescription, taken long-term to keep the effect. |
| UroLift® | Small implants lift and hold prostate tissue away from the urethra. | A device passed through the urethra; no cutting, heating or removal of tissue. |
| PAE | Reduces blood flow to parts of the prostate so it shrinks. | A catheter placed through an artery in the wrist or upper thigh; no tissue is removed. |
| TURP, ThuLEP, HoLEP, Aquablation | Remove prostate tissue that blocks the urethra. | Surgery through the urethra under anesthesia; a catheter is needed afterward. |
Before the procedure
- A consultation to review your urinary symptoms, medical history and current medications.
- Tests to understand your prostate and bladder, which can include a urine test, a measure of urine flow, an ultrasound and other imaging of the pelvic blood vessels.
- Instructions about eating and drinking beforehand and about blood thinners or other medications you take.
- Arranging for someone to drive you home.
During the procedure
- You receive sedation, and the skin over an artery in your wrist or upper thigh is numbed.
- A catheter is inserted into the artery through a small puncture, with no surgical incision.
- Using X-ray imaging and contrast dye, the catheter is guided to the arteries that supply the prostate.
- Microspheres are released to reduce blood flow to the targeted areas, usually on both sides of the prostate.
- The catheter is removed and pressure or a closure device is used at the puncture site.
What to expect after PAE
PAE is performed by an interventional radiologist working with Advanced Urology, in an outpatient setting. You will rest and be observed for a few hours before going home. Many men return to light activity within a few days; your care team will tell you when you can resume exercise, heavy lifting and other activities.
Because the prostate shrinks gradually, urinary symptoms usually change over the following weeks to months. Follow-up visits track your progress.
What are the side effects of prostate artery embolization?
As with any procedure, PAE has risks. Short-term effects that are commonly described include:
- Urinary frequency, urgency or burning for a short time
- Mild pelvic or rectal discomfort
- A low-grade fever, nausea or tiredness for a few days
- Small amounts of blood in the urine, stool or semen
- Bruising or soreness where the catheter was placed
Less common risks include infection, urinary retention and unintended blockage of blood flow to nearby organs such as the bladder or rectum. Your doctor will explain the risks that apply to you and what to watch for after you go home.
Prostate artery embolization in Georgia
Men's Health Georgia is part of Advanced Urology, with 14 offices across metro Atlanta and north Georgia, including Snellville, Marietta, Johns Creek and Decatur. Start with a BPH evaluation by one of our urologists to review every option. If PAE fits, it is performed by an interventional radiologist working with Advanced Urology, in an outpatient setting.
Prostate artery embolization FAQ
What is prostate artery embolization?
PAE is a minimally invasive, catheter-based procedure for an enlarged prostate (BPH). Tiny particles are placed in the arteries that feed the prostate to reduce its blood supply, which makes the prostate shrink and can ease pressure on the urethra.
How is PAE different from UroLift or TURP?
UroLift and TURP are done through the urethra: UroLift holds prostate tissue out of the way with small implants, and TURP removes tissue. PAE is done through a blood vessel in the wrist or upper thigh and works by shrinking the prostate. No tissue is cut or removed and nothing is passed through the urethra for the procedure itself.
Does PAE require general anesthesia?
PAE is generally done with local anesthetic at the catheter site and sedation, rather than general anesthesia. Your care team will explain the plan for your procedure.
Who performs PAE, and do I stay in the hospital?
PAE is performed by an interventional radiologist working with Advanced Urology, in an outpatient setting. You are observed for a period afterward, and your care team will tell you when you can go home. Plan for someone to drive you.
How soon will my symptoms change?
The prostate shrinks gradually, so changes in urinary symptoms usually develop over weeks to months rather than right away.
What side effects can happen after PAE?
Common short-term effects include urinary frequency or burning, mild pelvic discomfort, a low-grade fever or tiredness for a few days, small amounts of blood in the urine, stool or semen, and bruising where the catheter was placed. Less common risks include infection and unintended blockage of blood flow to nearby organs. Your doctor will review the risks that apply to you.
Who is a good candidate for PAE?
PAE is often considered for men with bothersome BPH symptoms who have not had enough relief from medication, who have a larger prostate, or who prefer to avoid surgery. Imaging and an evaluation of your symptoms and health help decide whether it fits.
What does PAE stand for?
PAE stands for prostate artery embolization, also called prostatic artery embolization. "Embolization" means blocking blood flow on purpose with tiny particles.
Who is not a candidate for prostate artery embolization?
PAE may not be suitable if you have an active urinary infection, prostate cancer that has not been evaluated, kidney problems or an allergy that limits the use of contrast dye, severe narrowing or twisting of the pelvic arteries, or certain bladder problems such as large bladder stones or a bladder that does not empty because of weak muscle. Your evaluation checks for these.
What should I expect after a PAE procedure?
You rest and are observed for a few hours, then go home with someone driving you. Expect a few days of urinary frequency or burning, mild pelvic discomfort and tiredness. Urinary symptoms change gradually over weeks to months as the prostate shrinks.
Do you need a catheter after PAE?
Many men do not need a urinary catheter after PAE, because nothing is passed through the urethra for the procedure itself. Some men need one for a short time, for example if they already use a catheter or have trouble urinating afterward.
Does prostate artery embolization affect ejaculation or erections?
PAE does not cut or heat tissue inside the urethra, which is one reason some men consider it. Some men notice less semen or blood in the semen for a time. Ask your doctor how PAE compares with other options for sexual function in your situation.
How long does prostate artery embolization last?
For many men, symptom relief lasts for years, but the prostate can continue to change and symptoms can come back. If that happens, PAE can sometimes be repeated, or another BPH treatment can be considered.
Can prostate artery embolization be repeated?
Yes, in some cases. Another BPH procedure, such as UroLift, HoLEP or TURP, also remains an option after PAE.
Is PAE covered by Medicare or insurance?
Medicare and many insurance plans may cover PAE when it is medically necessary to treat BPH. Coverage depends on your plan, and our staff can help you check your benefits; see insurance.
Talk with a urologist
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