Why Prostatic Artery Embolization Is a Better Choice for Older Adults With Enlarged Prostate

What is Benign Prostatic Hyperplasia (BPH) and how does it affect older adults?

Benign Prostatic Hyperplasia (BPH) becomes increasingly common with age. As the prostate enlarges, it compresses the urethra, leading to symptoms such as:

• Frequent urination
• Urgency
• Weak urinary stream
• Repeated nighttime urination (nocturia)

For older adults, these symptoms can impact sleep, mobility, and independence. Many seniors also have additional medical conditions, which makes choosing the safest and least stressful treatment especially important.

What is TURP and why can it be challenging for seniors?

Transurethral Resection of the Prostate (TURP) is a standard surgical procedure that removes excess prostate tissue from inside the urethra.

While effective, TURP carries additional risks for older adults:

Procedure-related:

• Requires general or spinal anesthesia
• Higher chance of bleeding
• Catheterization for several days
• Longer hospital stay

Potential complications:

• Infection
• Electrolyte imbalance
• Longer recovery time
• Sexual side effects (especially retrograde ejaculation)

For seniors with heart disease, diabetes, kidney issues, or mobility limitations, these risks may be significant.

What is PAE and how does it work?

Prostatic Artery Embolization (PAE) is a modern, minimally invasive alternative to surgery. It works by reducing blood flow to the prostate, causing it to shrink naturally over time.

Performed through a tiny pinhole in the wrist or groin, PAE offers multiple benefits for older adults:

• Local anesthesia only
• Minimal blood loss
• Same-day discharge
• Lower risk of postoperative complications
• Quick, comfortable recovery
• Very low risk of sexual side effects
• Safe for patients unfit for surgery or on blood thinners

PAE is performed by an interventional radiologist using advanced imaging guidance for precision and safety.

Why is PAE often the better option for geriatric patients?

1. Is PAE safe for patients with other health conditions?

Yes. Older adults commonly live with conditions such as hypertension, diabetes, heart disease, and kidney issues. PAE avoids major anesthesia and reduces stress on the body, making it safer for medically complex patients.

2. Does PAE offer a faster, more comfortable recovery?

PAE’s recovery timeline is a major advantage over TURP, which may require days of hospitalization:

• Patients walk within hours
• Most resume daily activities quickly
• Pain and discomfort are minimal

This makes a significant difference for older adults with mobility challenges.

3. How does PAE affect sexual function?

TURP frequently causes retrograde ejaculation and may lead to urinary leakage. PAE has a much lower rate of sexual side effects, helping maintain confidence and quality of life.

4. Is PAE better tolerated by frail or elderly men?

Absolutely. Because PAE is minimally invasive and avoids anesthesia, older adults often experience:

• Less fatigue
• Fewer complications
• Easier long-term recovery
• Better overall treatment experience

Are there situations where TURP is still necessary?

TURP may still be recommended for:

• Extremely large prostates
• Severe urinary retention requiring urgent clearing
• Anatomical situations where PAE is not feasible

However, for most elderly men, PAE provides comparable symptom relief with far fewer risks.

What does all this mean for older adults with BPH?

BPH can greatly impact comfort, sleep, and daily functioning.

While TURP has been the traditional approach, PAE offers a safer, less stressful, and highly effective alternative, especially for seniors with medical conditions that make surgery risky. PAE combines excellent symptom relief with an easier recovery, fewer complications, and better preservation of natural function.

• Lower medical risk
• Faster recovery
• Less discomfort
• Better preservation of natural urinary and sexual function
• No need for major surgery

For older adults seeking a safer, more comfortable treatment choice, PAE represents the ideal balance of safety, comfort, and long-term results.

Still confused?

If you’re unsure which treatment is right for you, contact RIVEA for a clear, unbiased review of your case. A second opinion helps you understand all options, especially non-surgical ones like PAE, before making a decision.

Prostatic Artery Embolization at RIVEA is performed by Dr. Arjun Reddy. Dr. Reddy is one of Hyderabad’s leading interventional radiologists. He was the first to perform PAE in Hyderabad and is recognized for his expertise in minimally invasive, non-surgical and organ-preserving treatments.

Choose RIVEA for:

• Advanced imaging and precision-guided technology
• Expert interventional team
• Patient-centric, minimally invasive approach
• Transparent second opinions
• Faster recovery and no-hospital-stay procedures