Understanding Prostate Enlargement (BPH)
What is BPH?
Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, commonly affecting men over age 50. As the prostate grows, it presses against the urethra and bladder, causing disruptive urinary symptoms that impact daily life.
Diagnostic Process for Benign Prostatic Hyperplasia (BPH):
The diagnostic evaluation for BPH begins with a detailed medical history and a review of symptoms, often using the International Prostate Symptom Score (IPSS) to assess severity. A Digital Rectal Exam (DRE) is performed to evaluate the size and consistency of the prostate. Diagnostic imaging and additional tests may include a transrectal or pelvic ultrasound to measure prostate volume and, in select cases, an MRI for detailed prostate mapping.
Uroflowmetry is used to assess the strength of urine flow and detect any obstruction, while a Post-Void Residual (PVR) measurement checks for incomplete bladder emptying. A Prostate-Specific Antigen (PSA) test may also be ordered to help rule out prostate cancer.
Treatment Options for BPH:
Initial treatment often begins with lifestyle modifications and medications. Alpha-blockers, such as Tamsulosin, help relax the muscles of the prostate and bladder neck to improve urine flow. 5-Alpha Reductase Inhibitors, like Finasteride, work by shrinking the prostate over time. In many cases, combination therapy using both drug classes yields better results.
Prostate Embolization Form
For patients who are not candidates for or do not wish to undergo Prostate Artery Embolization (PAE), surgical options performed by urologists may be considered. These include Transurethral Resection of the Prostate (TURP), which is regarded as the gold standard and involves removing prostate tissue to relieve obstruction. Other surgical techniques include laser therapies such as HoLEP and GreenLight, which use laser energy to remove or vaporize tissue, and prostatectomy—either open or robotic—which is typically reserved for patients with very large prostates.
Prostate Artery Embolization (PAE): A Minimally Invasive, Non-Surgical Option
PAE is an outpatient, image-guided procedure that offers a safe and effective alternative for patients seeking to avoid surgery. It requires no general anesthesia and involves no surgical cuts. With a quicker recovery time and minimal disruption to daily life, PAE allows most patients to return to normal activity rapidly while achieving significant symptom relief.
Prostate Artery Embolization: What It Is & How It Works
PAE is an advanced, minimally invasive procedure performed by an interventional radiologist to relieve BPH symptoms by shrinking the prostate. This is achieved by blocking blood flow to the prostate, causing it to shrink over time.
- Minimally invasive – no incisions, no catheter, no general anesthesia
- Preserves sexual function (lower risk of erectile dysfunction and retrograde ejaculation compared to TURP)
- Outpatient procedure with fast recovery
- Significant reduction in urinary symptoms — success rate 85–95%
- Reduced risk of complications versus surgery
Benefits of PAE:
Pre-Operative Process:
Before undergoing Prostate Artery Embolization (PAE), patients will have a consultation to review their medical history and BPH-related symptoms. Imaging, typically a pelvic CT angiogram or MRI, is performed to map the prostate’s arterial blood supply and confirm suitability for the procedure. Pre-procedure lab work includes blood tests to evaluate kidney function, complete blood count (CBC), and a coagulation panel. Patients are instructed to remain NPO (nothing by mouth) after midnight before the procedure and to review their current medications—particularly blood thinners, which may need to be temporarily discontinued under medical guidance.
During the Procedure:
PAE is performed in an outpatient interventional radiology suite under conscious IV sedation. The patient remains relaxed but awake throughout. The procedure begins with a small puncture in either the groin (femoral artery) or wrist (radial artery). Using real-time X-ray guidance (fluoroscopy), a micro-catheter is navigated into the arteries supplying both sides of the prostate. Once positioned, the interventional radiologist injects tiny, biocompatible microspheres to block blood flow to the prostate. This controlled embolization causes the prostate to shrink over time, relieving pressure on the urethra and improving urinary symptoms. Afterward, the catheter is removed, pressure is applied to the access site, and a small bandage is placed. The procedure typically lasts 60–90 minutes.
Post-Operative Care:
Following the procedure, patients are monitored in an observation area for a few hours before being discharged home the same day. A urinary catheter is usually not required. Most patients experience mild, temporary symptoms such as pelvic cramping, low-grade fever, fatigue, or slight urinary urgency and frequency, all of which are part of the expected inflammatory response and resolve within days. Recovery is generally quick, with most patients returning to light activity within 1–3 days. Symptom relief occurs gradually over the course of 2 to 6 weeks as the prostate continues to shrink.
Common Symptoms of Prostate Enlargement (BPH)
- Frequent urination, especially at night (nocturia)
- Weak or interrupted urine stream
- Difficulty starting urination
- Urgency or inability to delay urination
- Feeling of incomplete bladder emptying
- Straining during urination
- In rare cases, urinary retention (inability to urinate)
Schedule Your Consultation Today
Take the first step toward better circulation and a pain-free life.
Call Vascular & Interventional Specialists of Alabama to schedule your personalized consultation and see if you’re a candidate for minimally invasive treatment
Why Choose PAE?
- No general anesthesia
- No catheter (in most cases)
- No cutting, no surgical instruments in the urethra
- Faster recovery with lower risk of sexual side effects
- Outpatient, walk-in/walk-out procedure
Surgical Options Are Available Through Urologists
While our practice specializes in non-surgical, minimally invasive solutions, we are happy to coordinate with urologists for patients who prefer or require surgical options.
Your Care, Your Choice
At Vascular & Interventional Specialists of Alabama, we focus on helping men regain comfort, confidence, and control with minimally invasive treatment options like Prostate Artery Embolization.
