When enlarged prostate symptoms significantly impact your quality of life, two primary treatment options often emerge as leading solutions: prostate artery embolization (PAE) and transurethral resection of the prostate (TURP). Both procedures effectively address benign prostatic hyperplasia (BPH), but they take fundamentally different approaches to achieving symptom relief.
At Seamless Medical Centers, we believe the best treatment decision comes from understanding all your options thoroughly. This comprehensive comparison examines these two proven treatments, helping you evaluate them based on your individual circumstances, health goals, and lifestyle preferences.
Understanding Both Procedures
Prostate Artery Embolization (PAE)
PAE is a minimally invasive procedure that reduces prostate size by blocking blood flow to the enlarged gland. An interventional radiologist performs PAE using real-time imaging guidance, inserting a tiny catheter through a small puncture to deliver embolic particles directly to the prostate’s blood supply.
The PAE approach:
- Targets the prostate’s blood supply system
- Causes gradual shrinkage over weeks to months
- Preserves prostate structure while reducing size
- Requires no surgical incisions or tissue removal
Transurethral Resection of the Prostate (TURP)
TURP surgically removes excess prostate tissue that’s blocking urinary flow. A urologist performs this procedure by inserting instruments through the urethra to cut away obstructing prostate tissue, creating a wider channel for improved urine flow.
The TURP approach:
- Physically removes obstructing prostate tissue
- Provides immediate improvement in urinary flow
- Requires surgical expertise and operating room time
- Involves tissue cutting and removal through the urethra
Detailed Procedure Comparison
Invasiveness and Approach
PAE:
- Single needle puncture (typically in groin or wrist)No surgical incisions or tissue removal
- Conscious sedation, avoiding general anesthesiaOutpatient procedure lasting 60-90 minutes
TURP:
- Access through the urethra with surgical instrumentsGeneral or spinal anesthesia required
- Operating room procedure lasting 1-3 hoursTypically requires 1-2 day hospital stay
Recovery Timeline
PAE Recovery:
- Same-day discharge to home
- Return to work: 3-7 days typically
- Full activity: 1-2 weeks
- Complete symptom improvement: 3-6 months
TURP Recovery:
- Hospital stay: 1-3 days typically
- Catheter required: 1-3 days post-surgery
- Return to work: 2-4 weeks
- Full activity: 4-6 weeksImmediate symptom improvement
The recovery difference is significant. Length and cost of hospitalization are lower for PAE, and most PAE patients return to normal activities weeks sooner than TURP patients.
Effectiveness and Outcomes
Symptom Relief Comparison
Recent research provides compelling comparisons between these treatments:
During a 12-month follow-up period, both PAE and TURP were comparable on the reduction in IPSS and QoL questionnaire, while TURP showed significant improvements in Qmax and in the reduction in prostate volume.
PAE outcomes:
- Significant improvement in urinary symptoms
- 20-30% average prostate volume reduction
- Gradual, progressive symptom relief
- High patient satisfaction rates
TURP outcomes:
- Immediate improvement in urinary flow
- More dramatic reduction in prostate volume
- Rapid symptom relief
- Well-established long-term effectiveness
Long-Term Success Rates
PAE long-term results:
- Sustained symptom improvement in 80-90% of patients
- Low rates of additional treatment needed
- Durable results lasting years
- Progressive improvement continuing up to 12 months
TURP long-term results:
- Excellent long-term symptom control
- Gold standard with decades of proven results
- Low retreatment rates
- Immediate and sustained benefits
Risk and Complication Profiles
PAE Safety Profile
The PAE procedure has a lower risk of urinary incontinence and sexual side effects when compared with more invasive surgical procedures.
Minor complications:
- Post-PAE syndrome (flu-like symptoms for 3-7 days)
- Temporary urinary frequency or burning
- Mild pelvic discomfort
Serious complications (rare):
- Bladder infection requiring antibiotics
- Temporary urinary retention
- Puncture site bleeding or hematoma
Overall complication rate:
Studies show complication and adverse events rates were higher in the TURP group rather than in the PAE group (60.6% vs. 35.5%).
TURP Risk Profile
Common complications:
- Retrograde ejaculation (75-90% of patients)
- Temporary urinary incontinence (5-10%)
- Urinary tract infection
- Blood in urine during healing
Serious complications:
- Significant bleeding requiring transfusion (2-5%)
- Urethral stricture requiring additional treatment
- Permanent incontinence (1-3%)
- TURP syndrome (rare but serious electrolyte imbalance)
Overall complication rate:
Higher than PAE, particularly for sexual side effects and bleeding complications.
Sexual Function Considerations
PAE and Sexual Health
Advantages:
- Minimal impact on sexual function
- Preserves ejaculatory function in most men
- No direct manipulation of sexual anatomy
- Gradual treatment process allows adaptation
Considerations:
- Some men report temporary changes during healing
- Long-term sexual function generally preserved
- Individual responses may vary
TURP and Sexual Health
Expected changes:
- Retrograde ejaculation in 75-90% of patients (semen goes into bladder)
- Fertility affected due to retrograde ejaculation
- Erectile function typically preserved
- Orgasm sensation usually maintained
Permanent considerations:
- Dry orgasms become the norm for most men
- Fertility requires medical intervention if desired
- Sexual satisfaction often remains high despite changes
Making Your Treatment Decision
Choose PAE if you:
- Want the least invasive option available
- Need to return to work/activities quickly
- Want to preserve sexual function
- Prefer to avoid surgery and general anesthesia
- Are comfortable with gradual improvement
- Have medical conditions that increase surgical risk
Choose TURP if you:
- Want immediate, dramatic symptom improvement
- Have very large prostate requiring significant tissue removal
- Are comfortable with surgical recovery
- Accept potential sexual function changes
- Want the most proven long-term treatment
- Have failed previous minimally invasive treatments
Important Factors to Consider
Medical considerations:
- Prostate size and configuration
- Severity of urinary symptoms
- Overall health and surgical risk
- Previous prostate treatments
- Current medications and medical conditions
Lifestyle factors:
- Work and family responsibilities
- Recovery time availability
- Sexual function priorities
- Risk tolerance
- Treatment preferences
Expert Consultation Process
During your consultation at Seamless Medical Centers, we’ll help you understand:
Your prostate profile: Size, anatomy, and how it’s affecting your symptoms
Treatment suitability: Which procedures are most appropriate for your situation
Expected outcomes: Realistic expectations for symptom relief and recovery
Risk assessment: Personalized evaluation of potential complications
Alternative options: Discussion of all available treatments including newer alternatives
The Seamless Medical Centers Approach
Our experienced interventional radiologists specialize in PAE while maintaining close relationships with urologists who perform TURP. This collaborative approach ensures you receive unbiased guidance about the best treatment for your specific situation.
Our evaluation process:
- Comprehensive symptom and medical history assessment
- Detailed imaging analysis of your prostate
- Discussion of treatment goals and preferences
- Honest assessment of expected outcomes for each option
- Referral coordination if surgical treatment is preferred
Moving Forward with Confidence
Understanding your options empowers you to make the best decision for your unique situation. The goal is effective BPH treatment that aligns with your health goals, lifestyle needs, and personal preferences.
Recent advances in both PAE techniques and patient selection have made this minimally invasive option increasingly attractive for many men. However, TURP remains an excellent choice for appropriate candidates, particularly those needing maximum tissue removal or immediate results.
Ready to explore your BPH treatment options?
Contact Seamless Medical Centers to schedule a comprehensive consultation. Our team will evaluate your specific situation, discuss all appropriate treatments, and help you make an informed decision about the best approach for your prostate health.









