BPH Treatment · University Urology, PC

Prostatic Artery Embolization (PAE) in Knoxville, TN

A minimally invasive, non-surgical option for enlarged prostate symptoms — no incision, no general anesthesia, and typically home the same day. Coordinated by University Urology with experienced interventional radiology partners.

Request a Consultation Call (865) 305-9254
No
Surgical incision
Same
Day
Outpatient discharge
Low
Sexual side effect risk
2–6
Wks
Typical onset of improvement

What is PAE?

A Non-Surgical Approach to Enlarged Prostate Relief

Prostatic Artery Embolization (PAE) is a minimally invasive procedure performed by an interventional radiologist to treat benign prostatic hyperplasia (BPH). Using image guidance through a small catheter inserted in the wrist or groin, tiny microspheres are delivered into the arteries supplying the prostate, reducing blood flow to the gland. Over the following weeks, the prostate shrinks and urinary symptoms improve.

PAE does not require a surgical incision, general anesthesia, or an overnight hospital stay. It is an established option for men with moderate-to-severe BPH symptoms who want to avoid surgery or who are not good surgical candidates.

At University Urology, we coordinate PAE referrals with trusted interventional radiology partners. Your urologist evaluates candidacy, reviews all BPH treatment options with you, and manages your follow-up care after the procedure.

PAE at a Glance

Key Procedure Details

  • Performed by Interventional radiologist, coordinated with your University Urology urologist
  • Setting Outpatient interventional radiology suite
  • Anesthesia Local anesthetic with light sedation — no general anesthesia required
  • Access Small catheter via wrist (radial) or groin (femoral) artery
  • Duration Approximately 1–2 hours
  • Discharge Home same day in most cases
  • Recovery Days; most return to normal activity quickly
  • Improvement Typically 2–6 weeks, continuing through 3 months
  • Sexual function Low risk of ejaculatory or erectile side effects

How It Works

What Happens During and After PAE

PAE is a well-established interventional radiology technique. Here is what the process looks like from your first visit through follow-up.

1

Urology Consultation & Candidacy Evaluation

Your University Urology urologist reviews your BPH symptoms, prostate size, prior treatments, and imaging. We discuss all appropriate treatment options — including PAE, UroLift, Aquablation, and others — and determine whether PAE is the right fit for your anatomy and goals.

2

Pre-Procedure Imaging

A CT angiogram or MRI of the pelvis is typically obtained before PAE to map the prostatic arterial anatomy. This allows the interventional radiologist to plan the approach and identify any anatomical variations that could affect the procedure.

3

The Procedure

A small catheter is inserted through the wrist or groin under local anesthesia and light sedation. Using real-time fluoroscopic guidance, the interventional radiologist navigates to the prostatic arteries and delivers tiny microspheres that reduce blood flow to the prostate. Both sides are typically treated. The procedure takes approximately 1–2 hours.

4

Recovery

Most patients go home the same day after a brief observation period. Some temporary pelvic discomfort, urinary frequency, or low-grade fever in the first few days is expected as the prostate responds to treatment. These symptoms typically resolve within a week.

5

Follow-Up with Your Urologist

Your University Urology urologist manages all follow-up after PAE. We assess symptom improvement, repeat objective measurements (uroflow, post-void residual), and address any concerns. Most patients see meaningful improvement by 6–12 weeks.

Patient Selection

Who Is a Good Candidate for PAE?

PAE is not the right treatment for every man with BPH. Your complete evaluation — including prostate size, anatomy, symptom severity, and prior treatments — determines whether PAE or another approach is most appropriate.

Likely a Good Candidate

  • Moderate-to-severe BPH symptoms (IPSS ≥8) not adequately controlled with medication
  • Prostate volume generally 40–200+ grams — PAE works across a wide size range
  • Desire to preserve ejaculatory function — PAE has low ejaculatory dysfunction rates
  • Preference for avoiding surgical anesthesia or incision
  • High surgical risk due to comorbidities making OR procedures less suitable
  • Prior failed or incomplete response to other minimally invasive BPH therapies

Requires Additional Evaluation

  • Significant median lobe enlargement — anatomy may limit PAE effectiveness
  • Severe atherosclerosis or tortuous pelvic vessels — may complicate catheter navigation
  • Renal insufficiency — contrast use requires careful consideration
  • Active urinary tract infection — should be treated before proceeding
  • Suspected or confirmed prostate cancer — PAE is a BPH procedure only; cancer must be ruled out or addressed separately
  • Prior pelvic radiation — vascular anatomy may be affected

Comparing BPH Treatments

How PAE Compares to Other BPH Options

No single BPH treatment is right for every patient. We match the procedure to your prostate size, anatomy, symptoms, and goals. PAE is one of several options we offer — not a default recommendation.

Scroll left/right to view full table →

Treatment Setting Recovery Prostate Size Ejaculation Best For
PAE IR Suite — Outpatient Days Any (40–200+ g) Typically preserved Non-surgical preference; high surgical risk; large glands
UroLift In-office / Outpatient Days Small–Medium Preserved Mild–moderate BPH; anatomy-dependent
iTind Outpatient Days Small–Medium Usually preserved Mild–moderate BPH; no permanent implant
Aquablation Hospital / Outpatient 1–2 weeks Medium–Large Varies by anatomy Medium–large prostates; robotic precision
Robotic Simple Prostatectomy Hospital 2–4 weeks Very Large (>80–100 g) Varies Very large glands; definitive long-term relief
Medical Therapy Outpatient None Any Preserved Mild symptoms; first-line before procedures

PAE row highlighted. Individual candidacy determined by complete evaluation. All procedures available at University Urology except PAE, which is performed by our interventional radiology partners.

Want to see the full BPH treatment program? Our Advanced BPH page covers every option we offer — including Aquablation, UroLift, iTind, and robotic simple prostatectomy.

View All BPH Treatments

Coordinated Care

PAE: Urology & Interventional Radiology Working Together

PAE requires the expertise of both a urologist and an interventional radiologist. University Urology manages the urologic evaluation, candidacy assessment, and all follow-up care. The procedure itself is performed by our experienced interventional radiology partners. This coordinated model ensures you have the right specialist at every step.

University Urology’s Role

  • Complete BPH evaluation and candidacy assessment
  • Review of all treatment options — not just PAE
  • Coordination of pre-procedure imaging and IR referral
  • All post-procedure follow-up, symptom monitoring, and objective testing
  • Management of any complications or need for additional treatment

Interventional Radiology’s Role

  • Pelvic vascular mapping and procedure planning
  • Catheter-based arterial access and navigation
  • Delivery of embolic microspheres under fluoroscopic guidance
  • Intra-procedure monitoring and technical execution
  • Immediate post-procedure care before discharge

Why Coordination Matters

PAE outcomes depend on both technical execution and appropriate patient selection. Men who are not good PAE candidates may do better with Aquablation, UroLift, or another surgical approach. Because we offer all BPH options in-house, our recommendation is never biased toward any single procedure — we recommend what is right for your anatomy and goals.

BPH Specialists at University Urology

Request a BPH Consultation Call (865) 305-9254

Why University Urology

The Most Complete BPH Program in East Tennessee

PAE is one of several advanced BPH options we offer. Because we have the full spectrum in-house, we recommend based on your anatomy and goals — not on what any one provider specializes in.

Full Spectrum of BPH Treatments

UroLift, iTind, Aquablation, PAE, robotic simple prostatectomy, and medical management — all available. The right procedure is selected based on your anatomy, not what we happen to offer.

East Tennessee’s Only Aquablation Program

Dr. Pickens is the only urologist in the region performing Aquablation — robotic, image-guided waterjet resection for medium to large prostates. A strong alternative for patients who want tissue removal without traditional surgery.

Unbiased Treatment Recommendations

Because we offer every BPH option ourselves, our recommendation is based entirely on what is right for you — not on what generates the most revenue or what a specialist happens to perform.

Coordinated IR Partnership

PAE is performed by experienced interventional radiology partners. University Urology manages evaluation, coordination, and all follow-up — so you have continuity of care throughout.

Thorough Pre-Procedure Evaluation

We complete a full BPH workup before any procedure recommendation — including symptom scoring, uroflow, post-void residual, PSA, and imaging or cystoscopy when indicated.

11 Locations Across East Tennessee

Convenient satellite clinics for initial evaluation and follow-up care. BPH consultations are available across our network — you don’t need to come to Knoxville for your first visit.

Frequently Asked Questions

Common Questions About PAE

How does PAE shrink the prostate?
PAE reduces blood flow to the prostate by delivering tiny microspheres into the prostatic arteries. With reduced arterial supply, the prostate tissue gradually shrinks over the following weeks. The prostate doesn’t disappear — but it reduces in volume enough to relieve urethral compression and improve urinary symptoms. Most patients see meaningful improvement by 6–12 weeks, with continued benefit through 3–6 months.
Will PAE affect my sexual function?
PAE has a significantly lower rate of ejaculatory dysfunction compared to surgical procedures like TURP or even some laser techniques. The prostatic arteries targeted during PAE are distinct from the nerves and structures responsible for ejaculation and erection. That said, no procedure is entirely without risk — your urologist will review your personal risk factors at consultation. For men who place high priority on preserving ejaculatory function, PAE and UroLift are among the options with the most favorable profiles.
Is PAE as effective as surgery?
PAE produces meaningful symptom improvement in appropriately selected patients, but it is generally not considered equivalent to tissue-removing procedures (TURP, Aquablation, or enucleation) in terms of magnitude of symptom relief and long-term durability. For men with very large prostates or severe obstruction, surgical approaches often produce more complete relief. The tradeoff is recovery time, anesthesia risk, and ejaculatory function. Your urologist will review what the evidence shows for your specific situation.
What is the recovery like?
Most patients go home the same day. The first few days may involve mild pelvic discomfort, urinary frequency or urgency, and possibly a low-grade fever — these are expected responses called post-embolization syndrome and typically resolve within a week. Most men return to desk work and light activity within a few days. Avoid strenuous activity for about a week. A temporary urinary catheter may be placed for a short period in some cases.
Can I have PAE if I have a large prostate?
Yes — PAE is actually one of the few BPH procedures that works across a very wide range of prostate sizes, including very large glands where some in-office procedures are less effective. Prostate size alone is not a contraindication. The more relevant factors are the arterial anatomy, degree of obstruction, and presence of a significant median lobe, which your imaging and evaluation will clarify.
Does insurance cover PAE?
PAE coverage has expanded significantly in recent years. Medicare and many commercial insurance plans now cover PAE for BPH when medically indicated. Coverage varies by carrier and plan, and prior authorization is typically required. Our team verifies your coverage before scheduling and assists with the authorization process. We also discuss self-pay options if insurance does not cover the procedure.
How do I know if PAE is the right choice for me?
The best way to answer that question is a consultation with one of our urologists. We review your symptoms, prostate size and anatomy, prior treatments, medication history, and personal priorities — then present all appropriate options with honest recommendations. Many men come in asking specifically about PAE and leave having chosen a different procedure that better fits their situation. That’s the right outcome of a good consultation.

Interested in PAE or Other BPH Options?

Schedule a consultation with our BPH team. We’ll review your complete picture and recommend the approach that’s right for your anatomy and goals.

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