Enlarged Prostate? An Innovative Treatment May Help You Sleep Through the Night Again

Take Your Pick – There’s More Than One Option

Depending on symptom severity, prostate size, overall health, and personal preferences, options can range from medications to minimally invasive procedures and surgery. Landing on the right option takes a hearty chat with an experienced physician or urologist.

One treatment receiving increased attention is Prostate Artery Embolization, or PAE.

“PAE is a non-surgical option, and it targets the problem at its source,” says Dr. Robert Esposito, interventional radiologist at Georgia Urology. “Interventional and diagnostic radiology is one of the newer fields of medicine that's continually evolving and leading the forefront of effective minimally invasive procedures.”

Traditional procedures treat the prostate through the urinary tract, but PAE works by reducing the blood supply to the enlarged prostate. A tiny catheter is inserted through a small puncture in the wrist or groin and guided to the arteries supplying the prostate. Once at the target site, tiny microspheres are then delivered into those vessels, reducing blood flow and causing the prostate to gradually shrink, sometimes by as much as 40%.

Since the urethra is avoided, injury to the urinary tract and scar tissue formation, common risks in other BPH treatments, are also avoided. It’s possible, however, that some patients might experience 3 to 7 days of mild pelvic cramping, increased urinary frequency, or a burning sensation as the prostate tissue shrinks. Know that all of these are normal side effects of the procedure, but don’t hesitate to contact your care team if anything feels unusual to you. PAE is considered an outpatient procedure, and most patients return home the same day.

For the right patient, PAE could make a world of difference. In a study of 1,075 patients, researchers found that one year after undergoing PAE, 66 percent of patients no longer required medication to manage prostate symptoms. Symptom scores improved dramatically after treatment and remained significantly improved even four to five years later.1 Also, men who undergo PAE still have access to other minimally invasive or surgical treatments in the future if needed.

Setting the Record Straight

There are some common misunderstandings floating around about enlarged prostate and associated therapies, and as we approach September – National Prostate Health Month, it’s a great time to clear up what’s fact – and what isn’t.

Myth: An enlarged prostate will lead to cancer.
Fact: BPH, or an enlarged prostate, is not cancer and does not increase the risk of developing prostate cancer. The two conditions can occur at the same time, but one does not cause the other.

Myth: Enlarged prostate and urinary symptoms are simply part of aging.
Fact: Yes, they are, but living with them isn't. Symptoms can often be treated effectively.

Myth: Treating BPH will cause erectile dysfunction.
Fact: Most treatments for BPH do not cause erectile dysfunction (ED). Certain surgical procedures can carry a risk of sexual side effects, which should be discussed with your doctor when choosing a treatment. PAE is considered "nerve sparing" and minimally invasive with exceptionally low risk of ED.

Myth: PAE is surgery.
Fact: PAE is a minimally invasive procedure. No prostate tissue is removed.

Myth: PAE is only for severe cases.
Fact: That's a blanket statement and not completely accurate. The best treatment, from medication to surgery and everything in between, depends on symptom severity, prostate size, anatomy, and personal goals. That said, this PAE delivers great results for men with larger prostates.

Myth: Choosing PAE eliminates future options.
Fact: That's just not true. If your symptoms return or change, talk to your doctor, because you still have a spectrum of options.

Stop losing sleep. Relief may be closer than you think.

Whether you're just beginning to notice symptoms or you've been dealing with them for years, get the conversation going with your urologist. You may not be able to stop getting older, but you don't have to plan your life around the nearest bathroom.

Dr. Robert Esposito is an interventional radiologist at IR Centers at Georgia Urology. He specializes in minimally invasive, image-guided procedures and embolization therapies, including prostate artery embolization (PAE), and other advanced interventions designed to treat conditions such as benign prostatic hyperplasia (BPH) without traditional surgery.

At Georgia Urology, Dr. Esposito is committed to expanding access to innovative, patient-centered options for men dealing with enlarged prostate and other urologic conditions, with a focus on treatments that prioritize recovery, quality of life, and individualized care.

Georgia Urology is one of the Southeast’s largest and most comprehensive urology practices, providing advanced urologic care for men, women, and children.

1. Bhatia, S., Bhatia, A., Richardson, A. J., Richardson, K., Issa, C., Kumar, J. G., Jalaiean, H., Kava, B., & Shah, H. N. (2025). Prostate Artery Embolization – Mid to Long-term Outcomes in 1075 Patients. Journal of Vascular and Interventional Radiology, 36(3). https://doi.org/10.1016/j.jvir.2024.11.002