Prostatic Artery Embolization for BPH
A comprehensive guide
What Is Prostatic Artery Embolization?
An enlarged prostate—also known as Benign Prostatic Hyperplasia (BPH)— is common and seen in almost 2 in 3 men above the age of 50. It can cause frequent urination, weak urine flow, urgency, and disrupted sleep.
Prostatic Artery Embolization (PAE) is a minimally invasive, image-guided procedure used to treat BPH. Unlike traditional surgery, PAE does not involve removing prostate tissue. Instead, it works by blocking the blood supply to the enlarged prostate, which causes it to shrink over time, relieving pressure on the urethra and improving urinary function.
PAE is performed by an interventional radiologist using advanced imaging to guide a catheter through the arteries to the prostate. Tiny particles are then injected to selectively block blood flow to the overgrown tissue.
Is PAE a reliable alternative to prostate surgery?
Yes. Multiple clinical studies and real-world experience suggest that PAE is a safe and effective non-surgical alternative to transurethral resection of the prostate (TURP) and other invasive procedures.
Clinical outcomes:
Success rates range from 75% to 90%, depending on patient selection and prostate anatomy.
Symptom relief begins within days to weeks, with significant improvements seen over 3–6 months.
Patients often experience improved urinary flow, reduced urgency and frequency, and less reliance on medications.
| Metric | PAE | TURP / Surgery |
|---|---|---|
| Invasiveness | Minimally invasive | Surgical, requires anesthesia |
| Hospital Stay | Outpatient | 1–3 days typical |
| Recovery Time | 1–2 weeks | 4–6 weeks |
| Sexual Side Effects | Very low risk | Higher incidence (ejaculatory dysfunction) |
| Long-Term Relief | Up to 5+ years | 10+ years in some cases |
PAE offers particular advantages for men who are poor surgical candidates or wish to avoid the risks of general anesthesia, bleeding, or sexual side effects associated with surgery.
How do doctors keep PAE safe?
PAE is a technically complex procedure that demands high-level expertise in vascular anatomy and embolization techniques. The procedure is safe when performed by experienced interventional radiologists who specialize in prostate artery navigation.
Key safety practices:
- Pre-procedural imaging (CTA or MRI) to map the arterial anatomy
- High-resolution fluoroscopy to guide catheter placement
- Selective embolization to avoid non-target tissue injury
- Real-time monitoring to ensure precise particle delivery
Complications are rare but may include temporary pelvic pain, mild urinary symptoms, or in very rare cases non-target embolization affecting nearby tissues. These risks are minimized through meticulous technique and advanced imaging guidance.
What makes a good PAE centre?
Choosing the right facility for PAE is crucial. The success and safety of the procedure depend significantly on the skill and experience of the interventional radiologist.
What to look for:
- Board-certified interventional radiologist with experience in prostate embolization
- Access to advanced imaging technologies (DSA, 3D angiography, CT planning)
- A centre that offers comprehensive diagnostic evaluation and follow-up care
- Willingness to discuss outcomes, success rates, and complication management
Questions to ask:
- How many PAE procedures have you performed?
- What is your success rate for symptom improvement?
- What kind of imaging will be used during the procedure?
- What follow-up care and imaging do you offer post-procedure?
A multidisciplinary team including urologists and radiologists can further enhance outcomes by ensuring coordinated care and proper candidate selection.
What are the preliminary results of PAE?
Most patients begin to notice improvements in urinary symptoms within 1 to 2 weeks after the procedure. As the prostate continues to shrink, relief becomes more pronounced over the next 1 to 3 months.
Typical Timeline:
Days 1–3: Mild discomfort, pelvic cramping, or urinary frequency (usually self-limited)
Week 1–2: Noticeable reduction in urgency and frequency
Month 1–3: Maximum symptom relief, including stronger stream and better bladder emptying
Patients typically undergo follow-up imaging (such as MRI or ultrasound) at 3–6 months to assess prostate volume reduction and blood flow changes.
Why choose RIVEA for Prostatic Artery Embolization
RIVEA is Hyderabad’s leading centre for minimally invasive therapies like Prostatic Artery Embolization. Our state-of-the-art imaging technology allows for the precision necessary in such a delicate procedure. Dr. Arjun Reddy, our co-founder and a highly experienced interventional radiologist, was the first to perform PAE in Hyderabad. His extensive training at Massachusetts General Hospital and Brigham and Women’s Hospital in Boston ensures world-class care for our patients.
Meet Dr. Arjun Reddy – Expert Interventional Radiologist
Dr. Arjun Reddy, MBBS, MD, FVIR, brings years of experience and a patient-centric approach to the RIVEA team. He has performed a wide range of image-guided, minimally invasive procedures and is recognized as a pioneer in the field of interventional radiology in India. Dr. Reddy made history as the first physician to perform PAE in Hyderabad.His focus on innovation, safety, and outcomes makes him a trusted choice for men seeking relief from BPH without undergoing surgery.