Prostate artery embolization (PAE) is a relatively new procedure that is used in men with benign prostate enlargement. It is based on an interventional radiology technique. The aim of PAE is to restrict the blood supply to the prostate and thereby achieve a reduction in the size of the prostate. For this purpose, small particles (microspheres) are inserted into the prostate arteries via a catheter to reduce the blood flow within the prostate. The effect usually only sets in after one to three months.

 As PAE is still a new procedure, there is not yet any sufficiently valid long-term data on its efficacy and range of side effects. Especially in patients with a large prostate, the long-term effectiveness has not been sufficiently proven. The same applies to older procedures such as TUNA, TUMT or microwave therapy. In comparison, ablative procedures (e.g. TURis, LIFE diode laser, HoLEP), in which excess tissue is removed during the procedure, have proven to be superior in terms of their effectiveness in scientific studies.

Complications after the procedure

Men who undergo PAE treatment have a significantly increased risk of developing postoperative urinary retention after the procedure. This means that the filled bladder cannot be emptied spontaneously. As the prostate initially swells after embolization, a bladder catheter is inserted after the procedure. In many cases, however, the wearing time is longer than after the use of ablative procedures.

In very rare cases, a so-called post-PAE syndrome may develop in the days following the procedure, with symptoms such as nausea, vomiting, fever, pelvic pain or painful and frequent urination. In rare cases, an infection can also occur at the puncture site or in the prostate, as well as a hematoma (bruise).