Men’s Health Month is the perfect time to have the conversation most men keep putting off. If you’re over 50 and waking up three times a night to use the bathroom, struggling with a weak urine stream, or feeling like your bladder never fully empties, you’re not alone — and you’re not out of options.
Benign prostatic hyperplasia, or BPH, affects roughly 50% of men between the ages of 51 and 60, climbing to over 90% in men over 80.¹ For decades, the standard playbook looked something like this: try medication, tolerate the side effects, and eventually resign yourself to surgery. But there’s a growing body of evidence pointing to a better path — one that’s minimally invasive, highly effective, and increasingly recognized as a superior alternative to traditional surgical approaches.
That path is called Prostatic Artery Embolization, or PAE.
What is PAE for an enlarged prostate?
PAE for an enlarged prostate is a non-surgical BPH treatment performed by an interventional radiologist. A tiny catheter is inserted through a small nick in the wrist or groin, guided using real-time imaging to the arteries supplying blood to the prostate. Tiny microspheres are then delivered to reduce blood flow to the enlarged tissue, causing the prostate to shrink gradually over the following weeks. No general anesthesia. No incisions. No hospital stay beyond a few hours.¹
The procedure has been refined over more than a decade of clinical practice and is now backed by a compelling body of research. Here’s why men over 50 should be paying close attention.
1. It Delivers Real, Lasting Symptom Relief
One of the most persistent myths about non-surgical BPH treatments is that they trade effectiveness for convenience. PAE challenges that assumption directly. Studies have consistently shown that PAE for an enlarged prostate produces significant and durable improvements in urinary symptoms, with patients reporting meaningful reductions in their International Prostate Symptom Score (IPSS) — the measure of BPH severity — at both one-year and five-year follow-ups.²
For men over 50 who have already tried and failed with medications like alpha-blockers or 5-alpha-reductase inhibitors, PAE for an enlarged prostate offers a path to relief that doesn’t require going under the knife. And for those who are newly diagnosed, it positions them to get ahead of the condition before it significantly diminishes quality of life.
2. The Sexual Side Effect Profile Is Far Superior to Surgery
This is the reason many men lean in when they first hear about PAE — and rightly so. Traditional surgical options for BPH, particularly transurethral resection of the prostate (TURP), carry well-documented risks of sexual dysfunction. Retrograde ejaculation — a condition where semen travels backward into the bladder during orgasm rather than exiting the body — occurs in up to 90% of men who undergo TURP.² Erectile dysfunction is also a recognized post-surgical risk.
PAE for an enlarged prostate, by contrast, has been shown in multiple studies to preserve sexual function. Most men report no change in ejaculatory function, and some even report improvements in erectile function following the procedure — likely due to reduced pelvic congestion and improved urinary health overall.² For men in their 50s and 60s who are in active relationships and concerned about intimacy, this distinction is not a minor footnote. It’s a defining reason to explore PAE for an enlarged prostate.
3. Recovery Is Measured in Days, Not Weeks
Men over 50 are often at the peak of their professional and personal responsibilities. The idea of a 4-to-6-week post-surgical recovery, with catheterization, restricted activity, and significant discomfort, is a real barrier to seeking care. It’s one of the primary reasons men delay treatment until their symptoms become truly disabling.
PAE for an enlarged prostate removes that barrier almost entirely. Most patients are discharged the same day or after a single overnight stay. The majority return to normal activity within 3 to 7 days.³ There is no general anesthesia hangover, no surgical wound to manage, and no catheter required in most cases. For the man who can’t afford — financially or emotionally — to step away from his life for weeks at a time, PAE changes the calculus of seeking treatment entirely.
4. It’s Safe for Men Who Aren’t Surgical Candidates
Not every man over 50 is a straightforward surgical candidate. Cardiovascular disease, diabetes, obesity, and anticoagulant therapy can all elevate the risk profile of traditional surgery to a point where urologists and primary care physicians are reluctant to recommend it. Historically, these men were left with medication management and a gradual worsening of symptoms as their only realistic path.
PAE changes that equation. Because it is performed under local anesthesia with light sedation, the cardiac and respiratory demands are dramatically lower than those of general anesthesia. The Society of Interventional Radiology recognizes PAE as an appropriate treatment option for men with comorbidities that increase surgical risk, making it a genuine lifeline for a significant subset of men over 50 who would otherwise have no effective intervention available to them.³
5. The Evidence Base Is Maturing — and It’s Compelling
When PAE for an enlarged prostate first emerged as a clinical option, skeptics were quick to demand long-term data. That data has now arrived. The landmark ROPE study, conducted in the United Kingdom, one of the largest prospective registries of PAE outcomes, demonstrated that the procedure is both safe and effective across a diverse patient population, with low rates of major complications and high rates of patient satisfaction.⁴ Randomized controlled trials comparing PAE directly to TURP have found that while TURP may produce slightly greater prostate volume reduction, PAE achieves comparable symptom improvement — with substantially fewer sexual side effects and a dramatically more favorable recovery profile.²
The medical community is listening. PAE is increasingly offered at academic medical centers and by fellowship-trained interventional radiologists across the country. Men over 50 who are doing their research and advocating for themselves in conversations with their physicians are finding that PAE is no longer an experimental curiosity; it is an evidence-backed standard of care.
Take action during Men’s Health Month
Men’s Health Month exists precisely because men have a long cultural history of avoiding medical conversations, particularly ones that touch on urinary function, sexual health, and aging. BPH is not a vanity issue. Untreated, it can lead to urinary tract infections, bladder damage, kidney complications, and a quality of life that shrinks quietly over time.
If you or someone you know is over 50 and managing the symptoms of an enlarged prostate, the conversation about PAE is worth having with your physician, with a specialist in interventional radiology, and with yourself. A non-surgical BPH treatment that preserves sexual function, requires minimal recovery time, and is backed by a maturing evidence base is not a compromise. For most men over 50, it may well be the superior choice.
If you’re experiencing an enlarged prostate and want to avoid surgery and a lengthy recovery, contact Alate Health to schedule a consultation.
References
- Roehrborn, C.G. (2005). Benign Prostatic Hyperplasia: An Overview. Reviews in Urology, 7(Suppl 9), S3–S14.
- Carnevale, F.C., et al. (2016). Quality of Life and Clinical Symptom Improvement Support Prostatic Artery Embolization for Patients with Acute Urinary Retention Caused by Benign Prostatic Hyperplasia. Journal of Vascular and Interventional Radiology, 24(4), 535–542.
- Society of Interventional Radiology. (2023). Prostatic Artery Embolization (PAE) for Benign Prostatic Hyperplasia. SIR Patient Information Resource. Available at: www.sirweb.org
- Ray, A.F., et al. (2018). Efficacy and Safety of Prostate Artery Embolization for Benign Prostatic Hyperplasia: An Observational Study and Propensity-Matched Comparison with Transurethral Resection of the Prostate. BJU International, 122(2), 270–282.
