What is Prostate Artery Embolization (PAE)?

Prostate Artery Embolization (PAE), a technique pioneered at the University of Miami Miller School of Medicine, is a minimally invasive treatment for benign prostatic hyperplasia – or BPH – is a fairly common condition as men age. Another term for BPH is prostate gland enlargement. BPH can lead to troublesome urinary symptoms, as well as bladder, urinary tract, or kidney problems.

Signs and symptoms of BPH may include:

• Difficulty starting a urination stream
• Dribbling at the end of urination
• Having to urinate frequently at night
• Increased urinary frequency or urgency
• Unable to completely empty the bladder
• Unable to urinate
• Urinary tract infections (UTIs)
• Urine that is pink in color due to the presence of blood
• Urine stream that is weak, or stops and starts

In the U.S., a surprisingly high number of men have an enlarged prostate or benign prostatic hyperplasia (BPH).

• 50% of men over age 50
• 70% of men age 60-69
• 80% of men age 70+

If you’re among them, the University of Miami Health System has answers. UHealth interventional radiologists have performed more than 1,000 minimally invasive, outpatient PAEs – more than any other institution in the United States.

According to a long-term study presented to the Society of Interventional Radiologists in 2023, participants were asked: “If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?” Before having PAE, the average score indicated “mostly dissatisfied,” but within a year of having the procedure, the response was “pleased,” a level of satisfaction that continued throughout the six years of the study. Read more.

When you talk to your doctor about PAE, it's important to know the right questions to ask.

How is Prostate Artery Embolization Performed?

Prostatic artery embolization, a technique pioneered at the University of Miami Miller School of Medicine, is performed through a small puncture in the wrist or the groin. A catheter is inserted through the artery and advanced towards the prostate. Once the catheter is positioned in the artery supplying blood to the prostate, tiny particles are injected that are lodged in the tiny branches within the prostate, blocking blood flow. The blockage of these branches is called embolization. The procedure is then repeated on the other side of the prostate. 

The procedure can take anywhere from 1-2.5 hours, depending on the location and size of the prostatic arteries. Most men will not feel any pain during the procedure except minor pinch at the access point in wrist or groin. Mild sedatives (like Versed and Fentanyl) are used to alleviate anxiety, however patients are awake during the procedure.

What to Expect

PAE is usually performed as an outpatient procedure and no general anesthesia is required. During the PAE procedure, also known as prostatic artery embolization, you’re given a mild sedative, but remain awake.

The procedure begins with a tiny incision in your upper thigh or wrist to gain access to your arterial system. Using specialized X-ray equipment, a doctor called an Interventional Radiologist (IR) guides a catheter (a small hollow tube) to the vessels that supply blood to your prostate.

Once the IR reaches this location, embolic material (small particles about the size of a grain of sand) is injected through the catheter and into these blood vessels, decreasing blood flow to your prostate. The IR then repositions the catheter in order to treat the other side of your prostate. Depriving the prostate of oxygenated blood will cause it to shrink, thereby improving your urinary symptoms.

When the IR has completed embolization of the prostatic arteries, the catheter is gently removed. The entire PAE treatment can typically take anywhere from one to four hours to perform.

Know the right questions to ask your doctor.

What is Benign Prostatic Hyperplasia (BPH)?

An enlarged prostate gland, also called BPH, is a common condition in older men. This condition can cause problems with urination, like having to urinate frequently.

If You Have BPH, You Have Options

Normally the size of a walnut, the prostate gland sits below the bladder and surrounds the urethra (the tube that moves urine from the bladder out of the body). BPH is not cancer and it does not raise your risk for prostate cancer.

Discover the Advantages of PAE

As a treatment option, PAE is a safe alternative for men with BPH and, like other minimally invasive procedures, has meaningful advantages over traditional surgery.

One year after having the procedure, the average prostate size has shown to shrink by approximately 30%, easing a patient's urinary symptoms, sparing erectile function, and improving the overall quality of life. Men who have undergone PAE have reported experiencing a high degree of satisfaction, which was also sustained during the first year following the procedure.

A number of benefits:

• Minimally invasive procedure
• Can be performed as an outpatient procedure
• 1 week recovery
• Less need for catheter use (for most patients)
• No sexual side effects. No risk of Erectile dysfunction or retrograde ejaculation
• No risk of incontinence leakage surrounding healthy tissue
• Minimal pain and swelling
• Lower risk of erectile dysfunction.
• Can be performed on moderate or large size prostate gland with no upper size limit
• PSA counts generally drop to very low levels after the procedure
• Less than 1% complication rate
• Relieves lower urinary tract symptoms (LUTS) such as feelings of urgency and frequency especially at night (nocturia), incomplete bladder emptying, weak urine stream, intermittency, and straining while urinating

Why Choose UHealth?

UHealth - The Leader in Prostate Artery Embolization: The Department of Interventional Radiology at UHealth has two of the world’s most experienced physicians offering Prostate Artery Embolization, a minimally invasive treatment for BPH. Having the most extensive expertise PAE, UM interventional radiologists have performed more than 1,000 minimally invasive, outpatient PAEs – more than any other institution in the United States. PAE provides long lasting relief for urinary problems from BPH. PAE can be used in variety of BPH presentations including, very enlarged prostate glands (over 80 gms)(1,2), urinary retention (inability to urinate)(3) and hematuria (bleeding from enlarged prostate)(4). In addition, PAE is also safer and easier on the patients who have failed prior traditional BPH treatments, including transurethral resection of the prostate (TURP), Greenlight laser, Urolift or Rezum.

Innovative, expert multidisciplinary approach to urology care: Our interventional radiologists work in collaboration with nationally and internationally recognized experts in field of Urology. We use the latest research and the least invasive procedures to help you feel better and recover more quickly. Our multidisciplinary team will help design a personalized treatment plan to give you the best possible results.