Prostate Artery Embolization

What is prostate artery embolization (PAE)?

Prostate artery embolization (PAE) is a minimally invasive treatment performed by an interventional radiologist to treat benign prostatic hyperplasia (BPH), also called an enlarged prostate. The procedure blocks blood flow to the prostate, causing it to shrink and reducing urinary symptoms while avoiding traditional surgery.

At Columbia, our interventional radiologists perform prostate artery embolization as part of a multidisciplinary care team with our urology partners. A consultation with an interventional radiologist can help determine whether prostate artery embolization is the right treatment for you.

Who is a candidate for prostate artery embolization (PAE)?

Men with enlarged prostates and lower urinary tract symptoms (LUTS) that are affecting their quality of life are good candidates for prostate artery embolization. You may want to consult an interventional radiologist if you are experiencing symptoms such as:

• frequent urination
• incomplete emptying of the bladder
• difficulty urinating
• waking up at night to urinate (nocturia)
• incontinence

Patients who are ideal candidates for prostate artery embolization include men who:

• have moderate to severe lower urinary tract symptoms
• want to preserve sexual function.
• have had an adverse reaction to or side effects from medications.
• don’t want or might not be good candidates for surgery.

Your interventional radiologist will schedule an exam to determine if prostate artery embolization is right for you. The exam may include a health history, urine test, and diagnostic imaging to determine the size of your prostate and vascular anatomy. As with any medical intervention, discuss the most current clinical data with your interventional radiologist before deciding on a treatment.

How effective is prostate artery embolization (PAE)?

Studies show that close to 90 percent of patients experience improvement after prostate artery embolization, with many patients showing up to ten years of good results. Most patients are able to reduce or stop their BPH medications within 6 months after prostate artery embolization.

Additionally, prostate artery embolization does not prevent you from having other treatments for BPH in the future. If your symptoms return or additional treatment is needed, you may still be eligible for surgical treatment or a repeat prostate artery embolization.

Does prostate artery embolization require a catheter?

The vast majority of patients do not need a Foley catheter after prostate artery embolization. In certain situations, however, a temporary Foley catheter may be needed—for example, if you are unable to empty your bladder after the procedure or if you already require a catheter because of urinary retention. The risk of requiring a temporary Foley catheter after the procedure is rare, approximately three percent. 

Does prostate artery embolization affect sexual function?

No, prostate artery embolization does not typically negatively affect sexual function. Some other treatments for BPH—such as TURP or open prostatectomy—may be associated with sexual side effects, including erectile dysfunction.

Additionally, prostate artery embolization does not typically cause retrograde ejaculation, a condition in which semen enters the bladder rather than exiting through the penis during ejaculation. Preserving erectile and ejaculatory function is an important reason some patients choose PAE over other treatments for BPH.

How do I prepare for a prostate artery embolization (PAE)?

• A nurse will call you several days before your procedure to go over instructions, including stopping any medications you are taking. Be sure to follow the instructions you are given during the call.
• If you have an allergy to contrast, please notify us before your procedure.
• Make sure you have an escort over 18 years old to bring you home. 
• Do not eat or drink anything after midnight the night before your procedure, except for small sips of water with medications.
• On the day of your procedure, wear comfortable clothing and leave all valuables at home.

What will happen during a prostate artery embolization (PAE)?

• Prostate artery embolization is performed through a pinhole-sized needle entry (less than 2 mm) into an artery in either your wrist or groin. There are no large incisions or surgical wounds, and patients go home with only a small band-aid over the access site.
• After you arrive at our outpatient office, a nurse will escort you to the interventional radiology recovery area and ask you to change into a hospital gown. 
• We will make sure you are comfortable on the procedure table. Our nurse will then administer moderate sedation through an intravenous (IV) line and local anesthetic to numb the skin over your wrist or groin.
• An interventional radiologist will insert a needle into the numbed area. This needle provides access for a catheter, which is a long, thin tube.
• Under live X-ray imaging, the interventional radiologist will guide the catheter through your blood vessels to the one of the prostatic arteries, up to the point where it divides into multiple smaller vessels.
• Once the catheter is in place, we will inject contrast dye, which enables us to see the individual blood vessels in the area.  
• We then slowly inject an embolic (blocking) agent into the artery through the catheter. The embolic agent will be either synthetic particles the size of grains of sand or medical grade glue. The embolic agent flows with the blood toward the prostate and becomes wedged in the vessels supplying the prostate with blood.
• Once the blood flow is completely blocked, the interventional radiologist moves the catheter to the other side of the prostate to repeat the process.
• When the embolization is complete, we gently remove the catheter. The entire procedure usually takes less than ninety minutes. 
• You will then recover in your own private area until you are ready to go home, about two hours after the completion of the procedure 

What will happen after a prostate artery embolization (PAE)?

After your prostate artery embolization, you will likely need four days at home to recover. Most people feel back to normal within two weeks.

• Most men experience stinging or burning when urinating, or a general feeling of pelvic pain, immediately after the procedure. We usually treat your discomfort with an intravenous pain medication while you are in our recovery area and then switch to an oral medication that you can take at home.
• You may also experience some nausea or a low-grade fever following the procedure. We usually prescribe a short course of post-procedure antibiotics to prevent infection.
• Symptoms usually last for a few days, decreasing significantly after the first 12 hours.
• Most men feel fully recovered within two weeks of their procedure.
• Most men experience improvement in their symptoms within three weeks of their procedure.
• By three months, symptoms from BPH are often significantly improved or nearly completely resolved.
• We will schedule a follow-up appointment for about three weeks after your procedure.
• We will coordinate with your urologist to order imaging tests to check the size of your prostate, as well as obtain a PSA, between three and six months after your procedure.

Is prostate artery embolization safe?

Yes, prostate artery embolization is safe when performed by an experienced interventional radiologist. Your doctor will discuss the risks and benefits based on your medical history. 

How painful is a prostate artery embolization (PAE)?

During the procedure, you will feel sleepy and should not feel pain. There will be some pain after the procedure, especially in the first 12 hours. We will prescribe pain medications to help with discomfort.

What are the benefits of prostate artery embolization (PAE)?

Prostate artery embolization is less invasive, has fewer risks, and has a shorter recovery time than many other treatments for BPH. Advantages include:

• Prostate artery embolization is usually performed as an outpatient procedure in a medical office, so you don’t have to go to the hospital.
• Prostate artery embolization is performed under local anesthesia, or “twilight” sedation.
• There is no urinary catheter involved with a prostate artery embolization.
• There are no large incisions or stitches. You will go home with a Band-Aid on your wrist or your groin.
• There is a lower risk of complications compared to surgery.
• Recovery time is short.
• Prostate artery embolization typically has no long-term side effects, such as sexual dysfunction.

What are the risks of prostate artery embolization (PAE)?

As with any procedure, your interventional radiologist will discuss all risks during your consultation. Potential risks include:

• Allergic reaction: Some people have allergic reactions to contrast dye or sedatives, which we are well equipped to handle.
• Infection: This rarely occurs and can be successfully treated with antibiotics in most cases.
• Bleeding: You may experience mild bruising or bleeding at the arterial access site in your wrist or groin. We will monitor the access site closely during your recovery and make sure there are no concerning signs of bleeding before you go home.

How long does a prostate artery embolization last?

Prostate artery embolization has excellent long-term results, often 10 years or more. Some men will experience a return of their symptoms and will need to repeat the procedure.

Is prostate artery embolization covered by insurance?

PAE is a treatment option recognized by the American Urological Association (AUA) guidelines for men with lower urinary tract symptoms due to BPH.

Prostate artery embolization is covered by Medicare Part B and most major private health insurance plans when deemed medically necessary. Coverage usually requires prior authorization, a documented history of lower urinary tract symptoms from an enlarged prostate (BPH), and proof that other more conservative treatments like medications failed. Our team will work with your insurance company to obtain any necessary authorization before your procedure.

Medically reviewed by Raghuram Posham, MD
Last updated 8/27/2026