No single option is best for everyone. The right treatment depends on prostate size, symptoms, health, and personal priorities.
Many men experience urinary symptoms as they get older due to an enlarged or swollen prostate. Common problems include:
Getting up multiple times at night to urinate
Rushing urgently to the toilet during the day
Weak or slow urine flow
Difficulty emptying the bladder
If medications are no longer helping, many men assume that traditional surgery (TURP) is the only next step. However, there are now less invasive alternatives, one of which is Prostatic Artery Embolisation (PAE).
What is Prostatic Artery Embolisation (PAE)?
PAE is a minimally invasive treatment for urinary symptoms caused by an enlarged prostate (benign prostatic hyperplasia).
Instead of removing prostate tissue, PAE:
Reduces the blood supply to the prostate
Causes the prostate to gradually shrink
Relieves pressure on the urinary channel
How is PAE performed?
Performed in the X-ray department
Usually done by a specialist interventional radiologist
Typically an outpatient procedure
In simple terms:
A small catheter is inserted into an artery in the upper thigh
X-ray guidance is used to reach the prostate’s blood vessels
Tiny particles are injected to partially block blood flow
Over time, reduced blood supply causes prostate shrinkage
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What improvement can I expect?
PAE provides moderate but meaningful symptom relief for many men.
On average:
~50% improvement in urinary symptoms
30–50% improvement in urine flow
20–30% reduction in prostate size
Symptoms are commonly measured using the International Prostate Symptom Score (IPSS):
For example, a score of 24/35 may improve to around 12/35
How quickly will symptoms improve?
PAE works gradually.
No immediate relief
Improvement develops over weeks to months
Similar recovery timeline to other minimally invasive treatments such as Rezūm
How does PAE compare with other treatments?
Treatment | Invasiveness | Symptom Improvement | Speed of Improvement | Sexual Function | Durability |
|---|---|---|---|---|---|
Medications | Non-invasive | Mild–moderate | Weeks | Usually preserved | Ongoing use |
PAE | Minimally invasive | ~50% | Gradual (weeks–months) | Usually preserved | 3–5 years |
Rezūm | Minimally invasive | ~50–60% | Gradual | Usually preserved | 3–5 years |
UroLift | Minimally invasive | ~40–50% | Faster | Preserved | Variable |
TURP | Surgical | 70–90% | Immediate | Ejaculation often affected | Long-term |
No single option is best for everyone. The right treatment depends on prostate size, symptoms, health, and personal priorities.
How long does PAE last?
Most men remain satisfied for 3–5 years
10–20% may require retreatment due to:
Incomplete improvement
Recurrence of symptoms over time
What about sexual function?
One of the advantages of PAE is that sexual function is usually preserved.
Most men maintain erections and ejaculation
Around 5–10% may notice some change
What are the possible side effects?
PAE is generally safe, but potential side effects include:
Common and temporary:
Bruising or discomfort at the groin puncture site
Temporary urinary urgency or frequency
Burning with urination
Blood in urine or semen
Serious complications are uncommon, particularly in experienced centres.
Is PAE right for you?
PAE may be suitable if you:
Want to avoid surgery
Are not ideal candidates for general anaesthesia
Prefer a minimally invasive approach
A thorough assessment with a urologist is essential before deciding.
Key Takeaways
✔ Minimally invasive
✔ ~50% symptom improvement
✔ Gradual onset of benefit
✔ Sexual function usually preserved
✔ Retreatment needed in some men
Final thoughts
There is no “one-size-fits-all” solution for enlarged prostate symptoms. The goal is to choose a treatment that balances symptom relief, risks, durability, and quality of life.
If you are considering treatment options, discuss them with your urologist.