English
Hindi
Marathi
Urdu
Are you waking up multiple times every night just to use the bathroom? Is your urine stream weaker than it used to be, or do you feel like your bladder never fully empties? If these symptoms sound familiar, you are not alone. Millions of men across India deal with these issues as they age, and in the majority of cases, an enlarged prostate is the cause.
For decades, surgery was the standard answer. But today, there is a highly effective, minimally invasive option that most men have never heard of: Prostate Artery Embolization, or PAE. If you have been diagnosed with an enlarged prostate and are looking for an alternative to surgery, this guide by Dr. Amol Lahoti, Interventional Radiologist and Vascular Surgeon in Chhatrapati Sambhaji Nagar, will walk you through everything you need to know.
What Is an Enlarged Prostate (BPH)?
The prostate is a small walnut-shaped gland that sits just below the bladder in men. Its job is to produce fluid that nourishes and transports sperm. As men age, it is extremely common for the prostate to grow larger, a condition called Benign Prostatic Hyperplasia, or BPH.
BPH is not cancer and is not life-threatening, but it can seriously affect quality of life. As the prostate enlarges, it squeezes the urethra, making it harder to urinate. Left unmanaged, BPH symptoms tend to worsen over time.
Common symptoms of BPH include:
• Waking up two or more times at night to urinate (nocturia)
• Weak or slow urine stream
• Difficulty starting urination
• Feeling that the bladder is not fully empty after urinating
• Sudden, urgent need to urinate
• Frequent urination during the day
• Dribbling at the end of urination
BPH affects roughly 50% of men in their 50s and up to 90% of men in their 70s and 80s. If medication has not provided enough relief, or if you simply want to avoid surgery, PAE offers a compelling option.
What Is Prostate Artery Embolization (PAE)?
Prostate Artery Embolization is a minimally invasive, image-guided procedure performed by an Interventional Radiologist. It works by reducing the blood supply to the prostate gland, causing it to shrink gradually. As the prostate gets smaller, the pressure it places on the urethra eases, and urinary symptoms improve significantly.
PAE does not involve any surgical cuts, removal of tissue, or stitches. It is performed through a tiny puncture, usually at the wrist or groin, about the size of a pinhole. Because of this, recovery is dramatically faster and more comfortable than traditional prostate surgery.
How Does PAE Work? A Step-by-Step Overview
The procedure is performed under local anaesthesia and mild sedation, so you remain comfortable and awake throughout. Here is what happens during PAE:
1. A small puncture is made in the wrist (radial artery) or groin (femoral artery). No incision, no stitches.
2. A thin, flexible tube called a catheter is carefully guided through the blood vessels using live X-ray imaging (fluoroscopy).
3. The catheter is navigated to the arteries that specifically supply blood to the prostate.
4. Tiny microspheres (microscopic particles, smaller than a grain of sand) are injected through the catheter into these arteries.
5. These particles block blood flow to the prostate. Without its blood supply, the prostate gradually shrinks over the following weeks.
6. The catheter is removed and the puncture site is closed with a simple pressure bandage.
The entire procedure typically takes 60 to 90 minutes. Most patients are discharged the same day or the morning after, and can return to light activities within a few days.
What Symptoms Can PAE Relieve?
As the prostate shrinks following PAE, the relief in symptoms can be substantial. Clinical studies have shown that PAE significantly improves urinary symptoms in the majority of patients, with results comparable to surgery in many cases.
Patients commonly experience improvement in:
• Frequency of nighttime urination (nocturia)
• Urinary urgency and the inability to hold urine
• Urine flow rate and stream strength
• Sense of incomplete bladder emptying
• Overall bladder control and confidence
• Quality of sleep and daytime energy levels
Most patients begin noticing improvement within 2 to 4 weeks. Maximum benefit is typically seen within 3 to 6 months as the prostate continues to reduce in size.
The Key Benefits of PAE Over Traditional Surgery
For many men, the decision to pursue PAE comes down to a straightforward comparison with the surgical alternative, known as TURP (Transurethral Resection of the Prostate). Here is how PAE stands apart:
• No general anaesthesia: PAE is performed under local anaesthesia and light sedation. This makes it a much safer option for older patients or those with heart conditions, diabetes, or other health concerns that increase surgical risk.
• No surgical incision: The only entry point is a tiny pinhole at the wrist or groin. There is no cutting, no stitching, and no visible scar.
• Preserves sexual function: PAE has a very low risk of causing retrograde ejaculation or erectile dysfunction, which are known complications of TURP surgery. This is a major consideration for many men.
• Faster recovery: Most PAE patients return home the same day or the next morning and are back to light activities within a few days. TURP typically requires 2 to 4 days in hospital and several weeks of recovery.
• Less post-procedure pain: Discomfort after PAE is mild and usually managed with simple painkillers. No long-term catheter is required in most cases.
• Effective for large prostates: PAE is particularly well-suited for men with very large prostates, where surgery carries higher risks.
PAE vs. TURP: A Quick Comparison
| Factor | PAE | TURP (Surgery) |
| Anaesthesia | Local + sedation | General or spinal |
| Incision | Pinhole only | Surgical cut required |
| Hospital Stay | Same day / overnight | 2 to 4 days |
| Recovery Time | 3 to 5 days | 2 to 4 weeks |
| Sexual Side Effects | Very low risk | Risk of retrograde ejaculation |
| Suitable for Large Prostates | Yes | Technically difficult |
| Suitable for High-Risk Patients | Yes | Higher risk |
Who Is a Good Candidate for PAE?
PAE is not suitable for everyone, and a thorough evaluation by an Interventional Radiologist is essential before the procedure is recommended. In general, PAE may be the right option if you:
• Have been diagnosed with BPH and confirmed enlarged prostate on ultrasound
• Are experiencing moderate to severe urinary symptoms that affect your quality of life
• Have tried medications (alpha-blockers or 5-alpha reductase inhibitors) without sufficient relief
• Want to avoid surgery due to personal preference, age, or other medical conditions
• Are concerned about the sexual side effects associated with TURP
• Have a very large prostate that makes traditional surgery technically difficult or risky
PAE may not be suitable if you have prostate cancer, severe kidney disease, or certain arterial anatomy that makes the procedure technically unfeasible. Your doctor will assess this with imaging before recommending PAE.
What to Expect: Before, During, and After PAE
Before the Procedure
You will have a consultation with Dr. Amol Lahoti to review your symptoms, medical history, and recent investigations. A pelvic MRI or CT angiography is usually performed to map the prostate arteries and confirm suitability. Blood tests and a urine flow study are also typically required. You will be asked to fast for a few hours before the procedure.
During the Procedure
The procedure takes approximately 60 to 90 minutes. You will be awake, relaxed, and comfortable under local anaesthesia and mild sedation. The interventional radiology team monitors you throughout. You may feel mild warmth or pressure during the procedure, but pain is minimal.
After the Procedure
Most patients are observed for a few hours and discharged the same day or next morning. Mild pelvic discomfort, low-grade fever, and urinary urgency in the first few days are normal and settle within a week. You can return to desk work within 3 to 5 days. Strenuous activity should be avoided for 2 weeks. Follow-up imaging at 1 to 3 months confirms prostate reduction and symptom improvement.
Frequently Asked Questions About Prostate Artery Embolization
Q1. What is Prostate Artery Embolization (PAE)?
PAE is a minimally invasive interventional radiology procedure that reduces blood flow to an enlarged prostate by injecting tiny microspheres into its feeding arteries. Without adequate blood supply, the prostate gradually shrinks over weeks, relieving the urinary symptoms caused by BPH. It requires no surgical cuts, no stitches, and no general anaesthesia.
Q2. Is PAE a safe alternative to prostate surgery (TURP)?
Yes. PAE has a strong and well-documented safety profile. It avoids the risks associated with general anaesthesia, surgical incision, and the sexual side effects such as retrograde ejaculation that are common after TURP. It is particularly beneficial for older men or those with underlying health conditions that make surgery risky.
Q3. How long does PAE take to show results?
Most patients begin noticing improvement in urinary symptoms within 2 to 4 weeks of the procedure as the prostate starts to shrink. Maximum benefit is typically seen at 3 to 6 months. Results vary depending on the size of the prostate and individual factors, which your doctor will discuss with you.
Q4. Who is a good candidate for PAE?
Men diagnosed with BPH who have moderate to severe urinary symptoms, have not responded adequately to medication, and wish to avoid surgery are typically suitable for PAE. An MRI and consultation with an Interventional Radiologist is required to confirm suitability based on prostate size and arterial anatomy.
Q5. Does PAE affect sexual function?
Unlike TURP surgery, PAE carries a significantly lower risk of causing retrograde ejaculation or erectile dysfunction. Preserving sexual function is one of the most important advantages of PAE, and it is a key reason many men choose it over conventional surgical options.
Q6. Is PAE available in Chhatrapati Sambhaji Nagar?
Yes. Dr. Amol Lahoti, Interventional Radiologist and Vascular Surgeon at The Vascular Center, Century Multispeciality Hospital, Chhatrapati Sambhaji Nagar, performs PAE and other minimally invasive endovascular procedures. To book a consultation, call +91-9971121273.
Consult Dr. Amol Lahoti in Chhatrapati Sambhaji Nagar
If you or someone you know is struggling with the symptoms of an enlarged prostate, you no longer have to choose between living with the discomfort and undergoing major surgery. Prostate Artery Embolization offers a proven, safe, and effective middle ground that an increasing number of men are choosing every year.
Dr. Amol Lahoti is a certified Interventional Radiologist and Vascular Surgeon with over 7 years of experience in minimally invasive endovascular procedures at The Vascular Center, Chhatrapati Sambhaji Nagar. He and his team will evaluate whether PAE is the right treatment for your specific condition and guide you through every step of the process.
Modern treatment. Minimal invasion. Better quality of life.
To find out if you are a suitable candidate for PAE, book a consultation with Dr. Amol Lahoti today. Call +91-9971121273 or visit The Vascular Center, Century Multispeciality Hospital, Chhatrapati Sambhaji Nagar.