Enlarged Prostate Treatment Without Surgery | Prostate Artery Embolization Explained

Why It Matters

PAE provides a safe, outpatient alternative for men with large prostates or anticoagulant use, reshaping BPH treatment pathways and lowering procedural risk and cost.

Key Takeaways

• Prostate artery embolization (PAE) shrinks enlarged prostate without surgery.
• PAE avoids ejaculatory, erectile dysfunction, and incontinence risks.
• Suitable for glands ≥60 g, even up to 400 g, and anticoagulant users.
• Procedure uses tiny wrist/thigh puncture, local anesthesia, and same‑day discharge.
• Recovery is quick; patients resume normal activities within a week.

Summary

The video introduces prostate artery embolization (PAE), a minimally invasive radiologic procedure designed to shrink an enlarged prostate and alleviate lower urinary tract symptoms without traditional surgery.

Dr. Vicram March Buro explains that PAE avoids the bleeding, ejaculatory dysfunction, erectile dysfunction, and incontinence commonly associated with transurethral resection of the prostate (TURP) or aquablation. It is indicated for glands typically 60 g or larger—patients in the video range from 50 g to 400 g—and is especially attractive for men on anticoagulants who cannot pause blood‑thinners for operative interventions.

He describes the technique: a tiny needle accesses the arterial supply via the wrist or thigh, followed by embolic particles that gradually reduce gland volume. The procedure lasts one to two hours, uses only local lidocaine or twilight sedation, and patients can walk, use the bathroom, and be discharged after about an hour, often likening the experience to a spa visit with music.

By offering same‑day discharge, minimal pain, and a rapid return to daily activities, PAE expands therapeutic options for benign prostatic hyperplasia, potentially reducing hospital stays, surgical complications, and overall healthcare costs while meeting the needs of a growing anticoagulated patient population.

Original Description

If you're dealing with difficulty urinating due to an enlarged prostate, frequent urination, weak urine flow, or waking up at night, prostate artery embolization — or PAE — may be an option worth exploring.

Vikram Rajpurohit, MD, an interventional radiologist at NYU Langone Health, explains how prostate artery embolization (PAE) offers men with prostate enlargement a minimally invasive alternative to surgery. In this bph treatment, physicians deliver tiny beads through a catheter to reduce blood flow to the prostate, causing it to shrink, without general anesthesia or a hospital stay.

For many men, the decision to treat prostate enlargement comes down to side effects. Unlike surgical alternatives such as aquablation, Rezum, UroLift, or transurethral resection of the prostate (TURP), PAE does not cause ejaculatory dysfunction, erectile dysfunction, or incontinence, the concerns that most often lead patients to seek alternatives to surgery in the first place.

PAE is also an option for patients on blood thinners. Men taking aspirin, Eliquis, Coumadin, or Xarelto are candidates for the procedure, and unlike many surgical approaches, PAE does not require patients to stop taking blood thinners before treatment. Most patients return to normal daily activity within a week.

Learn how PAE can help with prostate gland and urinary problems to improve men's health.: https://nyulangone.org/conditions/male-urinary-dysfunction/treatments/prostate-artery-embolization-for-male-urinary-dysfunction

CHAPTERS:

0:11 What is prostate artery embolization?

0:19 Will PAE affect sexual function?

0:44 Who is a candidate for PAE?

1:31 How does prostate artery embolization work?

2:46 Advantages of PAE over other procedures

📞 To schedule a consultation with the NYU Langone Interventional Radiology team, call 212-263-5898 or visit: https://nyulangone.org/doctors/1891115887/vikram-rajpurohit

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