PAE vs. Simple Prostatectomy: Modern Approaches to BPH Treatment

When it comes to addressing urinary symptoms caused by benign prostatic hyperplasia (BPH), both Prostatic Artery Embolization (PAE) and simple prostatectomy are effective options, but they differ significantly in technique, recovery, and patient candidacy. Understanding these differences is crucial for selecting the treatment that best matches your individual health goals and lifestyle needs.

What is Prostatic Artery Embolization (PAE)?

PAE is an advanced, image-guided therapy performed by an interventional radiologist. This technique uses a small catheter inserted through the blood vessels in the groin. The radiologist then gently releases specially designed microparticles to block the blood supply to enlarged portions of the prostate. As blood flow diminishes, the prostate gradually shrinks, leading to substantial relief from urinary incontinence or urinary leakage.

What is Simple Prostatectomy for BPH?

A simple prostatectomy is a surgical procedure that removes the inner portion of the enlarged prostate gland. It is most commonly recommended for men with very large prostates or when other therapies have failed to provide adequate relief. During this surgery, a urologist removes the obstructing tissue either through an incision in the lower abdomen (open prostatectomy) or with minimally invasive techniques such as laparoscopic surgery. 

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“I was referred to Dr. W. Julian by my PCP and very happy that I was. Dr. Julian found a clogged artery that could have been life threatening if left untreated. My experience from consult to discharge was met courtesy, warmth and professionalism which helped me through my procedure. Sean greeted me and my son who explained the whole process and what to expect. I was also looked after by Josh, Jackie and Reuben who could not have been more supportive or communicative through this adventure.”

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PAE vs. Simple Prostatectomy: Procedure Comparison

Advantages of PAE

• Minimal downtime and recovery
• Suitable for men who are not good surgical candidates
• Lower risk because of its minimally invasive technique

Risks and Complications

PAE Potential Risks

• Temporary pelvic soreness
• Minor bleeding
• Infection 

Simple Prostatectomy Potential Risks

• Injury to surrounding tissues
• Infection and bleeding
• Retrograde ejaculation or dry ejaculation
• Urethral stricture (tightening of the urethra caused by scar tissue)
• Low risk of infertility

Long-Term Outcomes

• PAE and simple prostatectomy both have high success rates 
• PAE poses less risk of long-term sexual or urinary complications

Providers

William Julien, MD

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Board-Certified Vascular Interventional Physician

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Mana Khatkar, PA-C

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Certified Physician Assistant

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Anissa Rodriguez, NP-C

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Certified Nurse Practitioner

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Gina Lowy, PA-C

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Certified Physician Assistant

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Choosing the Best Treatment

At South Florida Vascular Associates, our team is committed to providing an in-depth review of all available BPH treatments so you can feel confident about your health plan. Our expert interventional radiologists can discuss these options in detail when you schedule a consultation at one of our three office locations.