Medical encyclopedia · Cochin AP-HP
Prostate embolization (PAE) vs TURP vs laser: which option for BPH?
Detailed comparison of minimally invasive and surgical treatments for prostatic hyperplasia: hospital stay, sexual function, risks and functional results
Cochin Hospital AP-HP · Prof. Anthony Dohan · Updated April 2026
| Criterion | Embolization (PAE) | RTUP | HoLEP | GreenLight KTP |
|---|---|---|---|---|
| Anaesthesia | Local + sedation | Spinal or general | General | Spinal or general |
| Hospital stay | 1 nuit | 2-4 jours | 2-4 jours | 1-3 jours |
| Recovery | 3-7 jours | 4-6 weeks | 4-6 weeks | 2-4 weeks |
| Retrograde ejaculation | < 5 % | 60-90 % | 75-90 % | 40-65 % |
| Erectile dysfunction | Nulle | 5-10 % | 5-10 % | 5-10 % |
| Efficacy on IPSS | High (−10 to −14) | Very high (−15 to −20) | Very high | Very high |
| Urethral stricture | Nul | Possible | Faible | Faible |
| Large prostates (> 80 mL) | Adapte | Difficile | Reference | Possible |
Major advantage of PAE: preservation of sexual function
Prostate embolization is the only BPH treatment that almost completely preserves ejaculation (risk of retrograde ejaculation < 5% vs 60-90% for TURP). This is a decisive criterion for young or sexually active patients.
Prostate embolization is the only BPH treatment that almost completely preserves ejaculation (risk of retrograde ejaculation < 5% vs 60-90% for TURP). This is a decisive criterion for young or sexually active patients.
How to choose between PAE and surgery?
PAE preferred if:
- Patient wishing to preserve sexual function (ejaculation)
- Contraindication to general or spinal anaesthesia
- Refusal of surgery
- Long-term anticoagulation
- Very large prostate (> 100 mL), as preparatory or definitive treatment
Surgery preferred if:
- Refractory complete urinary retention
- Associated bladder stones requiring removal
- Obstructive renal failure
- Need for histological confirmation
Frequently asked questions
Is prostate artery embolization as effective as surgery (TURP)?
Both improve urinary symptoms significantly, with IPSS improvement equivalent to TURP in most series at 1 year. TURP (the surgical gold standard) tends to give a greater improvement in peak urinary flow rate and prostate volume reduction, while embolization avoids general anaesthesia, preserves ejaculation and sexual function, and allows a same-day discharge. The choice is made with your urologist based on your priorities and prostate anatomy.
Can PAE be performed after a previous TURP?
Yes, PAE can be offered in case of recurrence after TURP. The residual prostatic vascularisation usually allows effective treatment.
What is the main advantage of embolization over TURP?
Ejaculation is preserved in the large majority of patients, compared with retrograde ejaculation in 60-90% after TURP. Embolization is also a day-case procedure under local anaesthesia.
Is it covered by insurance?
Yes. At Cochin AP-HP (a French public hospital), procedures are covered by national health insurance with no out-of-pocket fees. Contact ri.cch@aphp.fr or +33 1 58 41 46 12.
Does PAE preserve fertility?
As ejaculation is preserved, theoretical fertility is maintained. However, the impact of PAE on sperm quality is not fully documented. This question is discussed at the consultation if the patient is planning to have children.
Learn more
Prostate embolization at Cochin AP-HP
Procedure, technique, results and follow-up of prostate embolization.
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Why this page is trustworthy
Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.