Who is a Good Candidate for Prostate Artery Embolization?

This article was medically authored by Dr. Ryan Armstrong and last reviewed for accuracy on 09/12/2025.

The Food and Drug Administration now approves PAE, or prostate artery embolization, as a treatment for BPH, benign prostatic hyperplasia (also known as prostate enlargement.) Now, there are several ways to relieve the Lower Urinary Tract Symptoms (LUTS) associated with BPH, including lifestyle changes, medications, and even surgery. But when those interventions fail to offer relief from BPH symptoms, PAE can shrink your prostate to improve symptoms without surgery.

So, who is a good candidate for prostate artery embolization? We'll explain in a minute. But first, let's take a closer look at the types of symptoms you may experience with an enlarged prostate. Then, we’ll take a closer look at what's involved with this procedure, and who could be considered a PAE candidate.

Key Takeaways

• Ideal PAE candidates have failed to find symptom relief with other, non-surgical BPH symptoms, have acceptable kidney function, and wish to avoid surgery
• Prostate enlargement can lead to urinary tract symptoms such as urgency, nocturia and more
• Prostate Artery Embolization (PAE) is a minimally invasive procedure that relieves BPH symptoms by shrinking the prostate

What are the symptoms of an enlarged prostate?

As mentioned earlier, BPH symptoms often affect the lower urinary tract. These include:

• Frequent urination, or the need to pee more often. This can often lead to enlarged prostate sleep problems.
  The sudden, urgent need to urinate, even if you’ve recently emptied yourbladder
  
  
• Weak or interrupted urinary flow
  
  
• Difficulties starting the flow of urine
  
  
• Difficulties stopping the flow of urine, often resulting in dribbles of urine when you want to finish peeing
  
  
• Urinary retention, or an inability to completely empty your bladder, meaning you often have to pee shortly after going  

Less commonly, you may also experience

• Hematuria, or blood in your urine
• Urinary tract infections
• Kidney dysfunction
• Lowered libido
• Erectile dysfunction

Sometimes, lifestyle measures such as managing your fluid intake or following a special diet for enlarged prostate can provide symptom relief. Other times, medications like Cialis for BPH can help. However, if men have tried these non-invasive interventions but still experience BPH symptoms, PAE could provide needed relief, as long as you are a candidate for prostate artery embolization.

What does PAE involve?

Prostate artery embolization is a non-surgical procedure that alleviates the urinary symptoms associated with BPH. During the procedure, the interventional radiologists at Texas Endovascular use embolic materials (tiny particles that are safe for injection) to reduce blood flow to your prostate. By doing so, we can cause the enlarged gland to shrink, relieving symptoms in the weeks and months that follow your procedure.

In order to get the particles to their target zone, we thread a thin wire through an artery in your wrist or groin, gaining access with a small incision. We then guide the wire toward your prostatic arteries with the help of advanced imaging. Once the wire is in the right spot, we inject the embolic materials; blood flow to your prostate is immediately reduced.

In total, this outpatient procedure lasts about 90 minutes, and can be performed with moderate sedation. That means you'll be awake but comfortable, and you can avoid general anesthesia and overnight hospitalization, reducing both the costs and risks associated with this procedure.

Who is a candidate for prostate artery embolization?

PAE is a minimally invasive procedure and has a much lower risk of side effects when compared to surgery, especially when it comes to sexual side effects. However, some men may experience hematoria (temporary presence of blood in the urine), rectal bleeding, and the sudden inability to empty their bladders after PAE. Given these minor risks, this procedure is not for men who are able to relieve BPH symptoms with lifestyle changes or with medications.  

So, who is a candidate for prostate artery embolization? PAE is an option for men who suffer from BPH and who can't find symptom relief from other non-surgical procedures. It is equally effective whether your enlarged prostate is medium or large in size, according to this study. Good PAE candidates also include men who prefer to or must avoid invasive surgical procedures. However, in order to be a candidate for prostate artery embolization, you must have acceptable kidney function.

Ready to see if PAE is your pathway to BPH relief? We invite you to request a consultation at one of our seven locations in the greater Houston and Dallas regions. When you come into one of our offices, we can help determine your PAE candidacy! PAE is a minimally invasive procedure and comes with the risk of far less serious side effects than surgical procedures. However, some men may experience hematoria (temporary presence of blood in the urine), rectal bleeding, and the sudden inability to empty their bladders after PAE. This procedure is not for men who are able to relieve BPH symptoms with lifestyle changes or with medications.  

So, who is a candidate for prostate artery embolization? PAE is an option for men who suffer from BPH and who can't find symptom relief from other non-surgical procedures. It is equally effective whether your enlarged prostate is medium or large in size, according to this study. Good PAE candidates also include men who prefer to or must avoid invasive surgical procedures. However, in order to be a candidate for prostate artery embolization, you must have acceptable kidney function.

Ready to see if PAE is your pathway to BPH relief? Click here to request an appointment with our prostate specialists in Texas. When you come into the office, we can determine your PAE candidacy!