Introduction
As men age, certain health conditions become more common and can significantly impact daily life. One such condition is Benign Prostatic Hyperplasia (BPH), more commonly known as an enlarged prostate. Although not cancerous, this condition can lead to troubling urinary symptoms such as frequent trips to the bathroom, weak urine flow, difficulty emptying the bladder, and interrupted sleep at night. These problems may seem minor at first, but over time they can affect a man’s quality of life, self-confidence, and even long-term health.
For decades, the primary treatment options were medications or surgery. Drugs can ease symptoms but often need to be taken for life, with side effects that include dizziness, low blood pressure, weight gain or reduced libido. Surgery, particularly transurethral resection of the prostate (TURP), has been famous but comes with risks, longer recovery times, and sexual side effects like retrograde ejaculation or impotence. Today, however, men have access to a minimally invasive alternative that avoids many of these issues while giving similar benefits. Prostatic Artery Embolisation (PAE) is an advanced interventional radiology procedure that treats an enlarged prostate without the need for major surgery.
Why This Topic Matters in Men’s Health
BPH is incredibly common. Research shows that around half of men over 60 and nearly 90 percent of men over 80 will experience some degree of prostate enlargement. In places like Kerala and Thiruvananthapuram, this condition is becoming even more relevant because of ageing populations, greater health awareness, and lifestyle changes. For many men, the greatest concern is not only about symptom relief but also about preserving sexual function, maintaining independence, and avoiding major surgery.
Prostatic artery embolisation meets these concerns head-on. It is safe, effective, and provides long-lasting relief, with the added benefit of being minimally invasive. PAE represents a significant leap forward in men’s health, offering reassurance that treatment does not have to mean giving up quality of life.
Understanding Benign Prostatic Hyperplasia
The prostate is a walnut-sized gland that sits just below the bladder and surrounds the urethra, the tube that carries urine out of the body. Its main function is to produce fluid that nourishes and transports sperm. As men grow older, hormonal changes, particularly involving dihydrotestosterone (DHT), cause the gland to enlarge. This process is what doctors refer to as benign prostatic hyperplasia.
When the prostate becomes too large, it compresses the urethra and disrupts normal urine flow. This leads to what are known as lower urinary tract symptoms.
The most common complaints include:
- Needing to urinate frequently, especially at night
- Sudden and strong urges to urinate
- Difficulty starting urination
- Weak or interrupted urine stream Dribbling at the end of urination
- Feeling that the bladder is not fully emptied
What Is Prostatic Artery Embolisation?
Prostatic artery embolisation is a minimally invasive day-care procedure performed by an interventional radiologist. The aim is to shrink the enlarged prostate by cutting off its blood supply.
The procedure begins with a small puncture in either the groin or the wrist. Through this tiny opening, the radiologist inserts a catheter, which is carefully navigated into the arteries supplying the prostate using advanced imaging guidance. Once in position, tiny particles (size of fine sand particles) are released into the abnormal blood vessels. These block the blood flow to the prostate, causing the tissue to shrink over time.
Because the procedure targets blood supply rather than removing tissue directly, it avoids large incisions or cutting. It is performed under local anaesthesia with light sedation, meaning patients remain comfortable but do not require general anaesthesia. The entire process usually takes one to two hours, and most men go home the same day or after an overnight stay.
Who Can Benefit from PAE?
Not every man with BPH needs treatment. Some men have very mild symptoms that can be managed with lifestyle changes. But for those with moderate to severe urinary difficulties, prostatic artery embolisation can be an excellent option. It is particularly suitable for men who:
- Have persistent symptoms despite taking medication
- Prefer to avoid the side effects or lifelong use of drugs
- Are considered high risk for surgery due to age or medical conditions
- Wish to preserve sexual function and avoid complications such as incontinence
- Have very large prostates that make surgery more difficult
PAE is not recommended in men with prostate cancer, active urinary infections, or in certain cases where the arterial anatomy makes the procedure technically impossible. A full evaluation, including imaging tests and consultation with a specialist, is always necessary before deciding on the treatment.
Benefits of Prostatic Artery Embolisation
The appeal of PAE lies in its balance between effectiveness and safety. For most men, it offers relief that is comparable to surgery but without the same level of risk.
The benefits include:- A minimally invasive technique with no large incisions
- Quick recovery, with most men back to normal activities within a few days
- Preservation of sexual function, with far lower rates of erectile dysfunction or retrograde ejaculation than surgery
- Effective and lasting symptom relief, with studies showing significant improvement in urine flow and quality of life
- Short hospital stay
- Safe for men who are not candidates for surgery
However, UFE is not appropriate for women who are pregnant, those with active pelvic infections, or those with suspected cancer of the uterus. Though the result of any intervention or surgery for fibroids done in women hoping to conceive in the future should have similar results, they should have a detailed discussion with the IR to identify the exact cause of infertility and tailor the treatment according to the cause rather than offer blanket treatment options..
Risks and Possible Complications
Like any medical treatment, PAE is not entirely free of risks, but serious complications are rare. Some men may experience mild discomfort in the pelvic area, burning during urination, or a low-grade fever for a few days, which usually settles quickly. There is also a small risk of urinary tract infection, which can be treated with antibiotics.
An extremely rare complication is non-target embolisation, where the particles affect tissues outside the prostate. This is minimised by the skill and precision of the interventional radiologist, who uses advanced imaging to guide the procedure. Overall, the safety profile of PAE is excellent, and most men tolerate the procedure very well.
How PAE Compares to Other Treatments
For many years, medications and TURP surgery were the standard treatments for BPH. Medications are often the first step but can lose effectiveness over time, and they require daily use with possible side effects. TURP remains highly effective but involves general or spinal anaesthesia, hospitalisation, and longer recovery. It also carries risks of bleeding, infection, and sexual side effects.
Prostatic artery embolisation sits between these two extremes. It provides a minimally invasive procedure with durable benefits. Unlike drugs, it does not require long-term use, and unlike surgery, it avoids major risks and preserves sexual health.
Recovery and Life After PAE
One of the most attractive aspects of prostatic artery embolisation is how quickly men recover. Most return to normal routines within a few days, far sooner than after surgery. In the immediate aftermath, it is common to feel some increased urinary urgency or frequency, but this typically improves within weeks.
The prostate gradually shrinks over several months, and symptoms steadily improve. By three to six months after the procedure, most men notice a marked difference in their ability to urinate, their sleep quality, and their overall well-being. Long-term studies demonstrate that the benefits of PAE last for years, with a very low rate of needing additional procedures.
Follow-up appointments with the interventional radiologist are important to monitor progress. These may include physical examinations, urine flow studies, and imaging to confirm the reduction in prostate size.
Lifestyle Support for Prostate Health
Frequently Asked Questions
Is PAE effective?
Yes. Studies consistently show that over 85 percent of men experience significant improvement in urinary symptoms after the procedure.
Will my prostate shrink completely?
The prostate does not disappear, but it shrinks enough to relieve pressure on the urethra and improve bladder emptying.
Does PAE affect sexual function?
One of the main advantages of PAE is that it preserves sexual function. The risk of erectile dysfunction or retrograde ejaculation is much lower than with surgery.
How long does recovery take?
Most men resume normal activities within a few days. Full improvement of symptoms occurs gradually over several months.
Is PAE available in Thiruvananthapuram?
Yes. Prostatic artery embolisation is available in GG Hospital and Sree Gokulam Medical College in Thiruvananthapuram, performed by expert interventional radiologists.
Conclusion
Prostatic artery embolisation has redefined the way doctors manage benign prostatic hyperplasia. It is safe, minimally invasive, and provides long-lasting relief without the risks of major surgery. For men experiencing the bothersome symptoms of an enlarged prostate, PAE offers a new level of hope — the chance to reclaim comfort, sleep peacefully, and live without constant interruptions from urinary difficulties.
If you are living with symptoms of BPH and searching for alternatives to surgery or lifelong medication, a consultation about prostatic artery embolisation could be the step that transforms your quality of life.
