improvement
ejaculation
(outpatient)
❓ What is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH) : also called prostate adenoma : is a non-cancerous enlargement of the prostate gland that compresses the urethra and causes urinary symptoms. It affects 2 out of 3 men over 50 and up to 90% of men over 70.
Common symptoms include: frequent urination (especially at night), weak or interrupted urine flow, urgency, difficulty starting urination, and a feeling of incomplete bladder emptying.
🔵 How does prostate artery embolization work?
PAE uses the natural pathway of the blood vessels to reach the prostate without surgery. Tiny calibrated microspheres are injected into the prostatic arteries through a catheter introduced via a small skin puncture (femoral or radial approach). The prostate gradually shrinks as its blood supply is reduced, relieving urinary symptoms.
Pre-procedure consultation : IPSS score assessment, prostate MRI, uroflowmetry, PSA
Local anaesthesia : Outpatient or 1 night hospital admission
Catheter guidance : Under X-ray fluoroscopy, the catheter is guided to the prostatic arteries
Microsphere injection : Both prostatic arteries are embolised through a single skin puncture
Same-day or next-day discharge : Progressive improvement over 1–3 months
In the international literature, prostate artery embolisation offers improvement in urinary symptoms and quality of life comparable to surgery (TURP), with far fewer complications (around 35% versus 60% for TURP) and a shorter hospital stay. Surgery remains more effective on maximum urinary flow rate and volume reduction; the choice is made on a case-by-case basis with your urologist.
⚡ At a glance — key figures
Prostatic artery embolization (PAE) shrinks an enlarged prostate by selectively blocking its arterial supply through a catheter, under local anaesthesia, as a day case. Its decisive advantage over TURP: ejaculation is preserved.
| Criterion | Data |
|---|---|
| Clinical success | Around 80–90% improvement in urinary symptoms (IPSS score) |
| IPSS score | Typically from 24 down to 12 at 12 months |
| Prostate volume | Reduction of 20–40% |
| Ejaculation | Preserved — vs retrograde ejaculation in 60–90% after TURP |
| Anaesthesia / stay | Local anaesthesia — day case (vs 2–4 days after TURP) |
| Complications | Around 35% (mostly minor) vs about 60% after TURP |
| Cost | Covered by French national health insurance at Cochin AP-HP — no out-of-pocket fees |
Sources: UK-ROPE registry, BMJ studies, AFU and EAU guidelines. Surgery (TURP) remains more effective on peak urinary flow and volume reduction; the choice is made case by case with the urologist. Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.
📊 PAE vs Surgery : Comparison
| Criterion | 🔵 PAE : Cochin AP-HP | 🔪 TURP (surgery) |
|---|---|---|
| Anaesthesia | ✅ Local | ❌ General or spinal |
| Retrograde ejaculation | ✅ Never reported | ❌ Very common (65-90%) |
| Erectile dysfunction | ✅ Not caused by PAE | Risk exists |
| Hospital admission | ✅ 0–1 night | ❌ 2–4 nights |
| Recovery | ✅ Next day | ❌ 2–4 weeks |
| Success rate | ✅ >80% | >90% |
| Large prostates (>80cc) | ✅ Particularly effective | Technically difficult |
🤝 Multidisciplinary approach: PAE at Cochin is performed in close collaboration with the Urology Department of Cochin Hospital : ranked 2nd best urology service in France and 31st worldwide (2025). All cases are discussed in multidisciplinary meetings. urologie-paris-cochin.com →
🌍 For international patients
📋 Required before consultation
- Prostate MRI (mp-MRI) with measurements
- Recent PSA blood test
- Uroflowmetry (if available)
- IPSS questionnaire score
- Urologist's report
💰 Cost & insurance
Zero extra fees at Cochin Hospital AP-HP. Covered by French Assurance Maladie, EU EHIC, and most international private health insurance plans. Contact us for a cost estimate.
📋 IPSS Score
Before your consultation, complete the International Prostate Symptom Score (IPSS) questionnaire to assess the severity of your urinary symptoms.
Complete the IPSS questionnaire →📄 Patient Information Sheet
✅ Covered by French Assurance Maladie · Zero extra fees · EU EHIC accepted · English spoken
❓ Frequently asked questions
What is prostate artery embolization (PAE)?
Does prostate embolization affect sexual function?
What is the success rate of prostate embolization?
Is prostate embolization covered by French health insurance?
✓ 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.