Benign Prostatic Hyperplasia (BPH), or an enlarged prostate, affects more than half of men by age 50 and up to 90% of men over 80. The condition can cause uncomfortable urinary symptoms that disrupt daily life. Two of the most common treatment options are Prostate Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP). Understanding the differences between these procedures can help patients in Orange County make informed decisions about their care.
PAE is a minimally invasive procedure performed by an interventional radiologist. It involves making a tiny incision in the wrist or groin to access an artery. Using advanced imaging guidance, a small catheter is guided to the arteries that supply blood to the prostate. Microscopic, medical-grade beads are then injected to block these vessels, reducing blood flow to the prostate. This causes the enlarged prostate tissue to shrink over time, relieving pressure on the urethra and improving urinary symptoms.
TURP is a surgical procedure that has long been considered the gold standard for treating BPH. A urologist inserts a resectoscope through the urethra to the prostate and trims away excess tissue piece by piece, creating a wider channel for urine to flow through. There are no external incisions with this procedure. TURP is typically performed under general or spinal anesthesia and requires a hospital stay of one to two days.
When choosing between PAE and TURP, several key factors are worth considering. The following table provides a direct comparison of both BPH treatment options.
| Feature | PAE | TURP |
|---|---|---|
| Procedure Type | Minimally invasive | Surgical |
| Anesthesia | Local with light sedation | General or spinal |
| Hospital Stay | Outpatient (same-day discharge) | 1 to 2 days |
| Recovery Time | 24 to 48 hours | 4 to 6 weeks |
| Incisions | Tiny puncture in wrist or groin | None (through urethra) |
| Effectiveness | Over 80% symptom relief | 80% to 90% symptom relief |
| Sexual Side Effects | No reported negative effects | Dry orgasm is common |
| Incontinence Risk | Very low | Rare, but possible |
With PAE, patients typically return to normal activities within 24 to 48 hours. The procedure is performed on an outpatient basis, allowing recovery in the comfort of home. Mild discomfort is common but generally well tolerated. TURP requires a hospital stay of one to two days and a recovery period of four to six weeks. A catheter is typically needed for at least 24 to 48 hours after surgery, and strenuous activity, heavy lifting, and sexual activity are restricted for several weeks. Painful urination can also persist for some time after the procedure.
One of the most significant advantages of PAE is its low risk of sexual side effects. Clinical studies have shown no negative effects on erectile function or ejaculation, making it an attractive option for men who want to preserve their sexual health. TURP carries a higher risk in this area. Dry orgasm, also known as retrograde ejaculation, is a common and often permanent side effect that can affect fertility. There is also a small risk of erectile dysfunction following the procedure.
Both procedures offer long-lasting relief from BPH symptoms. The effects of TURP can last 15 years or more, although some men may require retreatment after several years. PAE has also been shown to provide durable symptom relief, with studies demonstrating sustained improvement for at least five years. While TURP may offer a slightly greater improvement in urinary flow rates, PAE delivers significant relief with a much lower overall risk profile.
PAE is an excellent option for men who want to avoid surgery and general anesthesia, are concerned about preserving sexual function, have other medical conditions that increase surgical risks, or prefer a faster recovery with minimal downtime. TURP may be recommended for men with a very large prostate, more severe urinary symptoms, or those who are willing to accept the risks and longer recovery associated with surgery. The best choice depends on the size of the prostate, overall health, and personal preferences.
Deciding on the best BPH treatment is a personal decision that should be made in consultation with a qualified medical professional. At VIS Orange County, our board-certified vascular and interventional specialists can help patients understand their options and determine whether they are candidates for Prostate Artery Embolization. We are committed to providing personalized care and helping each patient find the most effective solution for their needs.
Request an appointment here: https://visoc.org or call Vascular & Interventional Specialists of Orange County at (714) 560-4450 for an appointment in our Orange office.
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