Key facts
- What it treats: lower urinary tract symptoms from benign prostatic hyperplasia (BPH) — an enlarged, non-cancerous prostate.
- How it works: a catheter reduces blood flow to the prostate via its arteries, causing it to shrink and easing pressure on the urethra.
- Outcomes: clinical success (meaningful symptom relief) reported in around 90% of patients across recent meta-analyses, with results comparable to TURP over 12 months.
- Key advantage: large studies have found no adverse effect on erectile function — a significant difference from surgical options.
Prostate artery embolisation (PAE) is a minimally invasive, image-guided alternative to transurethral resection of the prostate (TURP) and other surgical options for men with lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) — the common, non-cancerous enlargement of the prostate that occurs with age.
How PAE works
A catheter is guided — typically from a small access point in the wrist or groin — into the small arteries supplying the prostate, under X-ray guidance. Embolic particles are then injected to reduce blood flow to the enlarged prostate tissue, causing it to shrink over the following weeks to months. As the prostate shrinks, pressure on the urethra eases, improving urinary symptoms.
What the evidence shows
Effectiveness: a 2025 systematic review and meta-analysis found PAE achieved a clinical success rate around 90%, with significant reductions in both symptom scores (IPSS) and quality-of-life scores. Large cohort studies — including one following over 1,000 patients — have shown sustained symptom improvement out to five years and beyond.
Versus TURP: studies comparing PAE directly with TURP found both achieved broadly comparable improvement in urinary symptom scores over 12 months, though TURP tends to produce a greater reduction in prostate volume and peak urinary flow rate. PAE, in turn, avoids the higher rates of sexual side effects associated with TURP.
Guideline recognition: PAE is now included in multiple international urology guidelines, including the American Urological Association's guidelines, as a recognised option for managing BPH-related symptoms — reflecting its maturing evidence base since the Society of Interventional Radiology's 2019 consensus position statement.
PAE compared with surgery
- No sexual side effects — studies have found no adverse impact on erectile function, unlike TURP and other surgical options
- Day-case or overnight procedure — generally a shorter hospital stay than TURP
- Preserves the prostate — no tissue is surgically removed
- Re-treatment possibility — prostate tissue can regrow in some patients, with re-intervention reported in around 20% of patients at five years
Who it suits
PAE is generally considered for men with moderate-to-severe urinary symptoms from BPH who haven't responded adequately to medical therapy, who want to avoid the sexual side effects associated with surgery, or who aren't ideal candidates for surgery due to other health factors. Suitability depends on prostate imaging and anatomy, assessed in consultation.
Common questions
What is prostate artery embolisation used for?
PAE treats lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) — an enlarged, non-cancerous prostate — such as urinary frequency, weak stream, and incomplete bladder emptying.
How effective is PAE compared with TURP?
Studies show PAE and TURP achieve broadly comparable improvement in urinary symptom scores over 12 months, though TURP tends to produce a greater reduction in prostate size and peak urinary flow rate.
Does PAE affect sexual function?
Large studies have found PAE does not have an adverse effect on erectile function, which is a meaningful advantage over surgical options that carry a higher risk of sexual side effects.
Is PAE a permanent solution?
Long-term studies show sustained symptom relief for most patients, though prostate tissue can regrow in some cases, with re-treatment rates of around 20% reported at five years.
Next step
Living with BPH symptoms?
Ask your GP or urologist about a referral, or get in touch directly to discuss suitability.
Get in touch