Can a very large prostate be treated with PAE?

Yes. A larger prostate does not prevent PAE. Prostate size, arterial anatomy, symptoms, bladder function, and overall health should be evaluated together.

Can PAE help someone who already has a urinary catheter?

PAE may be considered for selected patients with urinary retention or a long-term catheter. The likelihood and timing of catheter removal depend on bladder function and the reason for retention.

Can I have PAE if I take blood thinners?

Possibly. The medication, reason it is prescribed, bleeding risk, access plan, and ability to adjust treatment must be reviewed individually. Do not stop a blood thinner without instructions from the prescribing and treating physicians.

Is Prostate Artery Embolization Painful?

PAE is performed with local anesthetic at the access site, and sedation may be used for comfort. Learn more about what to expect from pain and discomfort during PAE

Who Is a Candidate for Prostate Artery Embolization?

Written and medically reviewed by Goke Akinwande, MD — Board-Certified Interventional Radiologist and Medical Director of MINT. Last reviewed: August 24, 2026.

doctor reviewing medical results on a tablet with a middle-aged male patient

Prostate artery embolization may be considered when bothersome urinary symptoms from benign prostatic hyperplasia (BPH) aren’t adequately controlled with medication or when you want to compare a minimally invasive option with surgery. Candidacy for prostate artery embolization (PAE) depends on more than urinary symptoms alone. Your prostate and arterial anatomy, bladder function, kidney function, medical history, and treatment goals all help determine whether the procedure may be appropriate.

Serving individuals in St. Louis, MO, and Chicago, IL, Midwest Institute for Non-Surgical Therapy (MINT) is led by Goke Akinwande, MD, a board-certified interventional radiologist with specialized expertise in minimally invasive, image-guided treatments. His background in interventional radiology is particularly relevant when evaluating whether an arterial procedure such as PAE fits your individual needs.

You May Be a Potential Candidate if You:

Have frequent or urgent urination
Wake repeatedly at night to urinate
Have a weak or interrupted urinary stream
Have difficulty starting urination
Feel unable to empty your bladder
Have not improved enough with medication
Experience unwanted medication side effects
Want to compare PAE with TURP and other BPH treatments
Have medical concerns that may affect surgical treatment
Place a high priority on minimizing recovery or certain urinary and sexual side effects

What Your Physician Will Review

Your symptoms

Your physician will review how often symptoms occur, how severe they are, and how much they affect sleep and daily life. A standardized urinary symptom score may be used.

The cause of your symptoms

BPH is common, but infections, bladder dysfunction, urethral narrowing, prostate inflammation, neurologic conditions, and medications may cause similar symptoms.

Your prostate

Prostate size and anatomy may be reviewed with ultrasound, MRI, CT, or other available imaging. Size is important, but it is not the only factor.

Your bladder function

Testing may assess urinary flow and how much urine remains in the bladder after urination. Long-standing obstruction can affect bladder function.

Your blood vessels and medical history

Kidney function, contrast history, arterial disease, blood-thinning medication, previous prostate treatment, and other health conditions may affect treatment planning.

When PAE May Not Be the Right Treatment

PAE may require more evaluation—or another treatment may be more appropriate—when:

Urinary symptoms are not primarily caused by BPH
An active urinary or prostate infection is present
Prostate cancer requires further evaluation or treatment
Arterial anatomy prevents safe access to the prostate arteries
Immediate urinary drainage or direct tissue removal is needed
Contrast-related or kidney risks cannot be adequately managed
Another treatment better fits the patient’s anatomy, bladder function, or goals

An online checklist cannot determine candidacy. The purpose of the consultation is to confirm the diagnosis, compare treatment choices, and determine whether PAE offers a reasonable balance of benefit and risk.

What to Bring to a PAE Consultation

A current medication and supplement list
Recent PSA results, if available
Prior urology notes
Prostate imaging or biopsy reports
Records of previous BPH treatment
A list of your most bothersome symptoms
Insurance information

Frequently Asked Questions

No. Some patients have already completed a urologic evaluation, while others may need additional urologic testing before treatment. Our team can help you navigate and get the appropriate pretreatment testing before your procedure.

Kidney function and contrast history are important because PAE commonly uses angiographic contrast. These issues do not have a universal online yes-or-no answer. The physician must assess severity, alternatives, and risk-reduction options.

The Best Way to Know Is to Be Evaluated

A symptom checklist can help you recognize possible BPH, but it cannot determine whether PAE is safe or appropriate for you.

Medical Disclaimer: This information is provided for educational purposes and is not a substitute for individualized medical advice, diagnosis, or treatment. Whether PAE is appropriate for you should be determined after evaluation by a qualified medical professional.