Prostate Artery Embolization

What is Prostate Artery Embolization?

PAE treats an enlarged prostate by working from inside the blood vessels. Through a pinpoint access in the groin, our interventional radiologist guides a thin intra-arterial catheter — under live X-ray imaging — to the small arteries that feed the prostate. There, microscopic particles (the “medicine”) are released to reduce the gland's blood supply. Deprived of that supply, the enlarged tissue softens and shrinks over the following weeks, relieving pressure on the urethra and restoring flow.

Then the catheter is removed. No cutting of the prostate. Nothing passed through the urethra. No urinary catheter to go home with. No implant left in your body. The access point in the groin is closed the same day, and most men are back to their routine within one to three days.

Why men choose PAE

Every other effective BPH procedure works through the urethra — and most either remove tissue, heat it, or leave an implant behind. PAE is the exception. It preserves sexual function, avoids the irritative healing phase of transurethral treatments, and treats prostates of virtually any size, including very large glands (well over 80–100 g) that disqualify men from Rezūm or UroLift.

PAE is also the standout option for men who can't have surgery — those on blood thinners, with cardiac or anesthesia risk, or who are catheter-dependent from urinary retention and want a path off the catheter.

The procedure, step by step

Before: a consultation with Dr. David Shusterman confirms BPH is the cause of your symptoms (and rules out anything else), with imaging to map your prostatic arteries.

The day of: you arrive at our outpatient center; no general anesthesia is needed. Dr. Yosef Golowa, our interventional radiologist, numbs a small spot in the groin and advances the catheter through the arterial system to each prostatic artery, embolizing both sides where anatomy allows. The procedure typically takes one to a few hours depending on anatomy. The catheter is withdrawn, the entry point is sealed, and after a short observation period you go home the same day.

After: some men notice mild pelvic discomfort, low-grade fever, or urinary frequency for a few days — “post-PAE syndrome,” a normal sign the treatment is working — managed with over-the-counter medication. We do not place a urinary catheter after PAE. The only men who go home with one are men who arrived with one: if you came to us already in retention, your existing catheter stays briefly to give the bladder time to recover, then we remove it. Your follow-up happens with our urology team, in the same office — flow improves progressively as the gland shrinks over weeks to about three months.

No one in New York City has done more PAEs

Prostatic arteries are small, variable, and often share origins with vessels you must not embolize. PAE is one of the most technically demanding procedures in interventional radiology, and published outcomes track closely with operator experience. We have performed over 1,000 PAE procedures — more than any other center in New York City — with minimal to no recorded side effects, including very large prostates and complex anatomy referred to us from elsewhere.

Behind that number is a structure that is likely unique in New York: urology and interventional radiology in one office. Dr. David Shusterman evaluates you thoroughly as a urologist and confirms PAE is the right answer. Dr. Yosef Golowa performs the embolization. Then you return to the urology team — the physicians most capable of managing your prostate health going forward — for all follow-up. At a hospital, those are three departments and three sets of records. Here, it's one hallway.

PAE vs. other BPH treatments

No single procedure wins on every line for every man — prostate size, anatomy, and your priorities decide. That's exactly why we offer the full range and start with an honest evaluation.