Prostate artery embolization (PAE) is a treatment to shrink an enlarged prostate. It uses a small tube (catheter) to send tiny particles called microspheres into the arteries that bring blood to your prostate. This lowers the blood flow to your prostate and helps it get smaller.

PAE is done to help with problems caused by an enlarged prostate (called benign prostatic hyperplasia, or BPH). The prostate is a small gland that's part of the male reproductive system. It sits just below the bladder. BPH is very common in people as they age. It’s not cancer, and it doesn’t raise your risk of getting prostate cancer. But it can cause problems that affect your daily life, such as:

• Having to urinate often, especially at night.
• Leaking or dribbling of urine.
• Having a weak stream of urine.
• Not being able to urinate or having trouble starting to urinate.

BPH can also lead to keeping urine in your bladder. That hurts your bladder and kidneys. It can also lead to bladder stones, blood in the urine, and urinary tract infections. If BPH keeps causing problems, your doctor can recommend treating it with lifestyle changes and medicines. Your doctor may also talk with you about other treatment options, such as PAE.

PAE is done by an interventional radiologist. That is a doctor who uses X-ray and other imaging technology to look inside your body and treat problems. You’ll probably be awake for the procedure, but your doctor may give you a sedative through a needle into your arm (medicine to help you relax). The doctor will also use medicine to numb the skin where the catheter is placed.

First, your doctor will insert the catheter into an artery in your wrist or groin. The doctor may use imaging technology to guide them, like fluoroscopy. (That's a type of X-ray.) Next, they’ll guide the catheter into the vessels that bring blood to your prostate. Once the catheter is placed, your doctor will inject the tiny particles that reduce how much blood flows to your prostate.

Before the procedure, your doctor will do an MRI, CT scan, or ultrasound. This will create a map of your blood vessels and find the arteries that bring blood to your prostate.

Make sure to tell your doctor about any medicines or supplements you take. This is especially important if you take blood thinners. Those medicines could cause problems during the procedure.

It's also important to follow any directions your doctor may give you for not eating or drinking before the procedure.

You’ll be able to go home from the hospital a few hours after the procedure. But you’ll need someone to drive you home.

In the days after the procedure, you might have some pain in your pelvic area, especially when urinating. You might notice small amounts of blood in your urine, stool, or semen, as well as flu-like symptoms. It's also common to feel that you have to urinate often or urgently. This is called post-PAE syndrome. While these symptoms can be uncomfortable, they usually go away within a few days. Talk with your doctor about how to manage symptoms.

Over the following weeks, your prostate will start to shrink. It might take a month or longer before you notice that your BPH symptoms are getting better. But once they do, the positive effects from the PAE may last for several years.

The most common side effects are pelvic pain, pain when urinating, feeling the need to urinate often, flu-like symptoms, and small amounts of blood in your urine, stool, or semen. These side effects usually go away within a few days.

Serious problems are rare, but they can happen. These include:

• Bleeding or infection, such as a urinary tract infection (UTI).
• Swelling of the prostate that blocks the flow of urine. This is called acute urinary retention.
• An allergic reaction to a medicine.

In rare cases, the tiny particles that are used to lower blood flow to your prostate can accidentally travel to other parts of your body and cause problems. This is called non-target embolization.

There is also a small risk of retrograde ejaculation after PAE. This means that during an orgasm, semen goes into the bladder instead of out through the penis. This doesn’t harm your health, but it affects fertility.