Florida’s leading non-surgical BPH program

Florida Interventional Specialists is the leading non-surgical treatment program for enlarged prostate in the state — and the largest academic medical center in Florida practicing prostate artery embolization. Patients across the country come to FIS for PAE, drawn by the depth of our experience and our results-driven care. Every procedure is performed at our state-of-the-art dedicated interventional radiology facility at Tampa General Hospital, ensuring specialized and consistent care throughout your treatment journey.

What is BPH, and how does PAE help?

The prostate is a small gland that sits beneath the bladder and wraps around the urethra. As men age, the prostate naturally grows. When that growth squeezes the urethra, urine has a harder time getting out. The medical name is benign prostatic hyperplasia (BPH), and the symptoms it causes are called lower urinary tract symptoms (LUTS) — weak stream, hesitancy, urgency, frequency, getting up multiple times at night, dribbling, and the feeling that the bladder never fully empties. In more advanced cases the bladder can stop draining altogether, leading to urinary retention and a Foley catheter.

PAE addresses the source of the obstruction directly. The arteries supplying the prostate are gently closed using tiny calibrated microspheres. With less blood flow, the gland shrinks, the urethra opens up, and symptoms ease.

What the day looks like

You’ll come to the dedicated IR facility at Tampa General Hospital in the morning. The procedure is done under local anesthesia with light sedation — no general anesthesia, no overnight stay. We numb a small spot on the wrist or groin and advance a thin catheter under live X-ray imaging into the right and left prostatic arteries. Calibrated microspheres are delivered selectively into those arteries, and the catheter is removed. The procedure takes 90 to 180 minutes, and most patients go home the same day.

For the first few days you may have mild pelvic discomfort, brief urinary frequency, and bruising at the access site — all normal and self-resolving. Most patients begin to notice improvement in 2 to 4 weeks, with continued benefit over 3 to 6 months. Men in urinary retention often have their catheter removed within the first few weeks.

PAE vs. TURP and other BPH procedures

Surgical and transurethral options work — and your urologist may have already discussed them. They include TURP (transurethral resection of the prostate), HoLEP (holmium laser enucleation), GreenLight PVP, UroLift, Rezum (water vapor therapy), aquablation, iTind, and for very large glands, simple prostatectomy. PAE is different in three ways that matter to most men:

• No transurethral instrumentation. The procedure is done from a small wrist or groin puncture — nothing is passed through the urethra.
• Sexual function preservation. TURP and HoLEP cause retrograde ejaculation in the majority of patients. PAE has a much lower rate and does not typically affect erectile function — one of the most common reasons men choose it.
• Effective for very large prostates, including glands over 80 grams and even over 150 grams, where TURP becomes suboptimal and surgery is otherwise the only option.

Multiple randomized controlled trials have compared PAE directly to TURP, with both showing meaningful symptom improvement. The right choice depends on your gland, your symptoms, and your priorities — a conversation FIS has with you and your urologist together.

Who is a good candidate?

Most men with bothersome BPH are candidates for PAE — particularly those with very large prostates, men who can’t tolerate or have failed medication (alpha blockers like tamsulosin, 5-alpha reductase inhibitors like finasteride or dutasteride), men in urinary retention dependent on a catheter, men prioritizing sexual function preservation, and patients with recurrent UTIs or bleeding from BPH. Candidacy is confirmed with imaging — a multiparametric prostate MRI or pelvic CT angiogram — and a coordinated review with your urology team.

References

1. Pisco JM, Bilhim T, Pinheiro LC, et al. Medium- and long-term outcome of prostate artery embolization for patients with benign prostatic hyperplasia: results in 630 patients. J Vasc Interv Radiol. 2016;27(8):1115–1122.
2. Carnevale FC, Iscaife A, Yoshinaga EM, Moreira AM, Antunes AA, Srougi M. Transurethral resection of the prostate (TURP) versus original and PErFecTED prostate artery embolization (PAE) due to benign prostatic hyperplasia (BPH): preliminary results of a single-center, prospective, urodynamic-controlled analysis. Cardiovasc Intervent Radiol. 2016;39(1):44–52.
3. Abt D, Hechelhammer L, Müllhaupt G, et al. 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;361:k2338.
4. Sapoval M, Thiounn N, Descazeaud A, et al. Prostatic artery embolisation versus medical treatment in patients with benign prostatic hyperplasia (PARTEM): a randomised, multicentre, open-label, phase 3, superiority trial. Lancet Reg Health Eur. 2023;31:100672.

Common questions

What is prostate artery embolization?

PAE is a same-day, image-guided, non-surgical procedure for an enlarged prostate (BPH). Tiny calibrated microspheres are delivered through a thin catheter into the arteries supplying the prostate, gently reducing the blood supply to the gland. Over the following weeks the prostate shrinks, urinary obstruction eases, and symptoms improve.

Why choose FIS for PAE?

Florida Interventional Specialists is Florida’s leading non-surgical BPH treatment program and the largest academic medical center in the state practicing prostate artery embolization. Patients across the country come to FIS for PAE. Every procedure is performed at our state-of-the-art dedicated interventional radiology facility at Tampa General Hospital, ensuring specialized and consistent care throughout your treatment journey.

How is PAE different from TURP and other BPH surgeries?

TURP, HoLEP, GreenLight PVP, simple prostatectomy, UroLift, Rezum, aquablation, and iTind are all surgical or transurethral procedures performed by urologists. PAE is performed by interventional radiologists from a small needle access in the wrist or groin — there is no transurethral instrumentation, no general anesthesia required, and the rate of retrograde ejaculation is much lower. Multiple randomized controlled trials have compared PAE to TURP, with both demonstrating meaningful symptom improvement.

Who is a good candidate for PAE?

Most men with bothersome BPH symptoms are candidates for PAE — particularly those with very large prostates (over 80 grams), patients who cannot tolerate or have failed medication, men in urinary retention with an indwelling catheter, men who want to preserve sexual function, and patients seeking a non-surgical option. Candidacy is confirmed with imaging (MRI or CT) and a coordinated review with the patient’s urology team.

Will PAE affect my sexual function?

Preservation of sexual function is one of PAE’s key advantages. Unlike TURP and HoLEP — where retrograde ejaculation occurs in the majority of patients — PAE has a much lower rate of retrograde ejaculation and does not typically affect erectile function. This is one of the most common reasons patients choose PAE.

How quickly does PAE work?

Most patients begin to notice improvement in urinary symptoms within 2 to 4 weeks, with continued benefit over 3 to 6 months. Patients in urinary retention often have their catheter removed within several weeks of the procedure.