Is There a Non-Surgical Treatment for an Enlarged Prostate?
Medically reviewed by Shayan Rashid, MD
Have you started planning road trips around rest stops?
Are you waking up two or three times a night to use the bathroom?
Or standing at the urinal waiting for a stream that takes its time?
For millions of men, these small daily frustrations are the first sign of a very common and very treatable condition: benign prostatic hyperplasia, better known as BPH or an enlarged prostate.
The good news is that an enlarged prostate is manageable, and the treatment options today extend well beyond medication and major surgery. One of the most patient-friendly is a minimally invasive procedure called Prostate Artery Embolization (PAE).
What is BPH (Benign Prostatic Hyperplasia)?
BPH is the non-cancerous growth of the prostate gland. The prostate is normally about the size of a walnut and weighs roughly 20 grams. As men age, it can grow to twice that size or more, and when it does, it can press against the urethra, the tube that carries urine out of the body, slowing or blocking the flow.¹
This growth is extremely common. Research shows that roughly 50% of men between ages 51 and 60 have BPH, climbing to about 70% of men in their 60s and more than 80% of men over age 70.² In other words, an enlarged prostate is closer to a normal part of aging than an exception, which is exactly why so many men brush off the symptoms.
Enlarged prostate symptoms to watch for
Many men assume urinary changes are just “getting older.” Some of these symptoms may point to BPH:
- Frequent urination
- A sudden or urgent need to urinate
- Difficulty starting the urine stream
- A weak or interrupted stream
- Straining to urinate
- A feeling that the bladder never fully empties
- Dribbling after you finish¹
These symptoms tend to creep up gradually, which is part of why they get ignored. Left untreated, BPH can worsen over time and, in some cases, lead to complications such as urinary retention, bladder damage, bladder stones, or recurrent urinary tract infections.¹
If any of this sounds familiar, it is worth a conversation with a specialist.
Is an enlarged prostate the same as prostate cancer?
This is usually the first worry men have, so let’s address it directly. The answer is no. BPH is a benign (non-cancerous) condition, and having BPH does not raise your risk of developing prostate cancer. The two can exist at the same time, but one does not cause the other.³
Because some symptoms of BPH and prostate cancer can overlap, your physician may recommend testing to identify the cause of your urinary symptoms and rule out other conditions. Getting evaluated is how you replace worry with answers.
Why men wait years to get help
It is common for men to live with urinary symptoms for a long time before saying anything. Some assume it is an unavoidable part of aging. Others feel awkward discussing bladder or prostate issues at all.
Urologists see this pattern constantly. Many men simply do not realize that effective, low-risk help is available and that treatment can meaningfully improve both sleep and quality of life. Early evaluation also helps prevent the complications mentioned above before they start.
Enlarged prostate treatment options
The right treatment depends on how bothersome your symptoms are and how large your prostate is. Broadly, the options fall into a few categories.
Watchful waiting: For mild symptoms, a physician may recommend monitoring the condition over time along with simple lifestyle adjustments, such as limiting fluids before bed and cutting back on caffeine and alcohol.
Medications: Drugs such as alpha-blockers and 5-alpha-reductase inhibitors can relax the prostate muscle or shrink the gland. They help many men but can come with side effects and must be taken indefinitely to keep working.
Surgical procedures: Traditional surgery, including transurethral resection of the prostate (TURP), is effective and remains a standard option, particularly for larger prostates or more severe cases.
Minimally invasive procedures: This category has grown significantly and includes Prostate Artery Embolization (PAE), an option that appeals to men who want to avoid traditional surgery and general anesthesia.
What is Prostate Artery Embolization (PAE)?
Prostate Artery Embolization is a minimally invasive, non-surgical procedure performed by an interventional radiologist, a physician who specializes in image-guided treatments. Working through a tiny pinhole in an artery, usually in the wrist or upper thigh, the physician guides a thin catheter to the small arteries that feed the prostate and releases microscopic particles that reduce the abnormal blood flow to the gland. With its blood supply scaled back, the prostate gradually shrinks over the following weeks, and urinary symptoms ease.
PAE is not brand new and experimental. The first PAE to treat BPH in humans was reported in 2008, and the procedure has been studied steadily ever since.⁴
Potential benefits of PAE
- No surgical incision (the access point is a small pinhole)
- Outpatient procedure, so most men go home the same day
- No general anesthesia
- Short recovery time compared with traditional surgery
- Meaningful symptom relief for most appropriate candidates
- Preservation of sexual function in many patients
What the research shows
PAE has been validated in randomized trials and large patient series:
- Across studies, the technical success rate of PAE ranges from roughly 86% to 100%.⁵
- In one of the largest long-term studies, following 630 men, clinical success was about 82% in the short term and held around 76% over the medium and longer term.⁶
- When compared directly with TURP surgery, PAE delivers comparable improvement in symptom scores and quality of life at 12 months. TURP tends to produce greater gains in urine flow rate and prostate shrinkage, while PAE is associated with fewer complications and shorter hospital stays. In one systematic review, complication rates were 35.5% for PAE versus 60.6% for TURP.⁵
No single treatment is right for everyone. PAE may not be appropriate in every case, and the only way to know if you are a candidate is a proper evaluation. But for many men seeking an alternative to traditional surgery, it is a strong option worth discussing.
Frequently asked questions about BPH and PAE
Is PAE painful?
Most men experience only mild discomfort. Some have temporary symptoms afterward such as mild pelvic discomfort, frequent urination, or a low-grade fever, which generally resolve on their own. Major complications are uncommon.⁵
How long is recovery after PAE?
Because there is no surgical incision, recovery is typically short. Many men return to normal activities within a few days, far faster than after traditional prostate surgery.
Will I still need to take BPH medication after PAE?
Many men are able to reduce or stop their medications after PAE, but this varies by individual. Your physician will guide you based on your results.
Does PAE affect sexual function?
One reason men choose PAE is its favorable profile here. Many patients preserve sexual function after the procedure, in contrast to some surgical options that carry a higher risk of sexual side effects.
Who performs PAE?
PAE is performed by an interventional radiologist, a physician with specialized training in minimally invasive, image-guided procedures.
Take charge of your health this Men’s Health Month
An enlarged prostate is common, it is not cancer, and it is highly treatable. If urinary symptoms are interrupting your sleep, your travel, your work, or simply your peace of mind, you do not have to keep tolerating them. Understanding your symptoms and learning about your enlarged prostate treatment options puts you in control of the decision.
At University Radiology Vascular & Interventional Center, patients are evaluated by experienced interventional radiology specialists who focus on image-guided, minimally invasive treatments like PAE. Our team takes a personalized approach, helping you understand all of your options so you can make a confident, informed decision.
Call (908) 874-9236 to schedule a consultation and learn more about your treatment options.
References
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Enlarged Prostate (Benign Prostatic Hyperplasia).
- Yale Medicine; Cedars-Sinai; American Urological Association. Benign Prostatic Hyperplasia (BPH) prevalence by age.
- American Cancer Society. Benign Prostatic Hyperplasia (BPH) and Prostate Cancer.
- Carnevale FC, et al. First reported use of prostatic artery embolization for BPH in humans (2008); narrative review, Journal of Clinical Medicine, 2025.
- Prostate Artery Embolization as Minimally Invasive Treatment for Benign Prostatic Hyperplasia: An Updated Systematic Review, PMC.
- Pisco JM, et al. Long-term outcomes of PAE in 630 patients.
