The prostate artery embolization alternative to TURP

Practically every man who lives long enough will develop specific symptoms of a condition called benign prostatic hyperplasia (BPH) as the prostate enlarges. Benign prostatic hyperplasia (BPH) occurs when the walnut-sized prostate gland has grown large enough to start squeezing the urethra. That pressure affects urine flow, which causes other associated symptoms resulting in quality of life issues for men that include the following:

  • A weak urine stream 
  • Difficulty starting a urine stream
  • Stopping and starting when having urinating
  • Urinary urgency when you suddenly have to find a restroom right away
  • Frequent nighttime bathroom trips to urinate disrupting sleep


Typically treatment for men whose BPH is not well-controlled by medications is to undergo a surgical procedure called transurethral resection of the prostate or TURP. While TURP can be an effective method for treating BPH, it is performed in the hospital, it requires recovery time, wearing a catheter in the bladder, and may cause erectile dysfunction as a side effect of the procedure.   


While many men can benefit from TURP, not all men do

Some men are not able to or don’t want to undergo invasive surgical procedures. For those men, there is another option for BPH called prostate artery embolization that provides a satisfactory improvement for 75-80% of men who undergo this procedure. 


Prostate artery embolization (PAE) is a non-surgical, interventional radiology alternative to TURP. This procedure can successfully treat an enlarged prostate by reducing urinary incontinence without sexual side effects. PAE works by reducing the blood supply to the prostate, which causes it to shrink. This procedure is performed by interventional radiologists, doctors trained to do minimally invasive vascular procedures such as angioplasty and embolization. 


To perform PAE, imagine a catheter about the size of a spaghetti noodle inserted into an artery through the leg by the interventional radiologist. The doctor will direct the catheter into blood vessels that supply the prostate using X-ray guidance. Once the catheter is positioned, tiny microsphere beads are injected into the prostate. The beads are like a gelatin, acrylic, and hybrid bead made in a lab. The tiny beads are slowly released into the prostate circulation to slow the supply of blood to the prostate down to a trickle. Once the procedure is complete, the prostate will begin to shrink. 


The advantages of PAE include:


  • It’s a 90-minute outpatient procedure
  • The patient does not experience pain or discomfort during the procedure
  • Recovery from PAE is faster than surgery
  • There are no incisions to heal or stitches to remove
  • Risk of bleeding or complications is less than surgery
  • Patients who’ve undergone PAE report high satisfaction

Like most procedures, there can be some minor side effects of PAE of which most resolve on their own within a few days:

  • Frequent or difficult urination
  • Pelvic pain
  • Blood in the urine and/or stool
  • Diarrhea 

Men with BPH deserve good quality healthcare. A thorough discussion with their healthcare provider on the advantages and disadvantages of both TURP and PAE for BPH can help guide men on their decision of which to use for treating BPH. 


Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911. 

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