Shrinking the prostate by cutting off part of its blood supply, without entering the urethra.
How it works
Prostatic artery embolization is performed by an interventional radiologist through a catheter, usually from the wrist or groin. Tiny particles are injected into the arteries feeding the prostate, reducing its blood supply so the gland shrinks over the following weeks and months.
Nothing passes through the urethra, and nothing is cut or removed.
Who it suits
It is worth considering for men with very large prostates, men who are poor candidates for anesthesia, and men who want to avoid any instrumentation of the urethra. It preserves sexual function well.
Improvement is gradual rather than immediate, because it depends on the gland shrinking over time.
What to weigh
The results are generally less dramatic than tissue removing procedures, and not every man responds. It requires an interventional radiologist experienced in the technique.
The workup matters here: a urethral stricture needs to be ruled out first, and a very large median lobe does not respond as well as the rest of the gland, so the anatomy has to be right.
For the man whose anatomy fits, particularly a larger prostate without a median lobe, PAE has one advantage worth its own sentence: it burns no bridges. Every other treatment remains available down the road.