PAE is a relatively new procedure that involves blocking the blood flow to the enlarged prostate using tiny particles. This can help reduce symptoms like urinary frequency and urgency. This procedure has been gaining in popularity in recent years, but there is still some confusion about what it is and what to expect. If you are a man with an enlarged prostate, you may be considering prostatic artery embolization (PAE) as a treatment option, but you may also be wondering whether the procedure is painful. In this blog, we will answer the question: does PAE hurt? by defining what the procedure is, explaining how it is performed, and discussing expectations in terms of sensation during the procedure, as well as during the recovery process.
What is PAE?
PAE is a minimally-invasive outpatient procedure that is performed using local anesthesia. A small catheter is inserted into the femoral artery in the groin and threaded up into the arteries that supply blood to the prostate. Once the catheter is in place, tiny particles are injected through it and into the prostate arteries. These particles cause blockages that reduce blood flow to the prostate.
How is PAE performed?
PAE is a minimally-invasive outpatient procedure that is performed using local anesthesia. As mentioned above, a small catheter is inserted into the femoral artery in the groin and threaded up into the arteries that supply blood to the prostate. Once the catheter is in place, tiny particles are injected through it and into the prostate arteries. These particles cause blockages that reduce blood flow to the prostate.
What can I expect in terms of sensation during the procedure?
During the PAE procedure , you will be given medication that will keep you relaxed for the duration of the procedure. You may feel a pinch or slight burning sensation when the local anesthesia is injected. Once the catheter is in place, you should feel little discomfort. You may notice a brief warm sensation when contrast dye is injected, and some men feel mild pelvic discomfort as the prostate arteries are blocked.
What can I expect in terms of sensation during recovery?
Most men who have PAE experience only mild discomfort after the procedure. For the first several days, however, it is common to have pelvic discomfort, burning or frequent urination, and sometimes mild fever or nausea (post-embolization syndrome), which usually respond to simple medications. You may also have some mild discomfort and bruising at the catheter entry site. Small amounts of blood in the urine, semen, or stool can also occur for a few days. These side effects are normal and should resolve on their own within a week or so. You should be able to return to your usual activities within a few days, but you should avoid strenuous activity for at least two weeks.
Does PAE hurt?
Overall, PAE is generally well tolerated, and most side effects are minor and temporary. You may experience some discomfort during the procedure or in the first days afterward, but this is typically mild and manageable with medication. Recovery is usually quick, with most men able to return to their usual activities within a few days. If you are considering PAE as a treatment option for your enlarged prostate, talk to your doctor to learn more about what to expect.
Sources
- Society of Interventional Radiology (SIR) 2026 Practice Guidance Document for Prostatic Artery Embolization. J Vasc Interv Radiol, 2026.
- Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026). American Urological Association, 2026.
- EAU Guidelines on the Management of Non-neurogenic Male LUTS. European Association of Urology, 2026.
- Randomised Clinical Trial of Prostatic Artery Embolisation Versus a Sham Procedure for Benign Prostatic Hyperplasia. Eur Urol, 2020.
- Comparison of prostatic artery embolisation (PAE) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia: randomised, open label, non-inferiority trial. BMJ, 2018.
- Enlarged prostate or benign prostatic hyperplasia (BPH) can be treated by interventional radiologists. Society of Interventional Radiology.
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