Interventional radiology and sexuality: preserving, not sacrificing

Quick answer

Interventional radiology treats several vascular causes of sexual and fertility problems: erectile dysfunction (venous leak), varicocele, pain during intercourse (pelvic varices), without surgery and while preserving sexual function.

📖 Treating without sacrificing sexuality

Many conditions treated by our department, such as prostate enlargement, uterine fibroids, pelvic varices and erectile dysfunction of venous origin, bear directly on intimacy and sex life. Yet the reference surgical treatments for these conditions often come at a cost to sexuality: retrograde ejaculation after prostate resection, uncertainty about fertility after myomectomy, and so on.

In many situations, interventional radiology offers an alternative that treats the disease without this compromise. This page brings together, condition by condition, what is precisely known about the impact of our techniques on sexuality, in both directions, without hiding the limits.

🔵 Prostate: preserving ejaculation

The reference surgical treatment for benign prostatic hyperplasia (transurethral resection, TURP) is effective on urinary symptoms, but causes retrograde ejaculation in 65 to 75% of cases: semen flows back into the bladder instead of being expelled, which is not painful but permanently changes the experience of orgasm and makes natural conception impossible.

Prostatic artery embolization works differently: it reduces the volume of the prostate by blocking its blood supply, without passing through the urethra or damaging the bladder neck. It preserves antegrade ejaculation in the great majority of cases and does not affect erections. It is today one of the arguments most often put forward by patients who choose this option.

→ Full details on prostate embolization

🔴 Uterine fibroids: preserving fertility

For a symptomatic uterine fibroid, surgery (myomectomy, or even hysterectomy) remains an option often considered, but it is not without risk for future obstetric outcomes: uterine scar, adhesions, sometimes complete removal of the uterus.

Uterine fibroid embolization does not increase the risk of infertility or of complications in future pregnancies compared with myomectomy, according to the data in the EMC reference article written by our team (Barat, Moyne, Jacquet, Barral, Soyer, Dautry, Vorachack, Dohan, 2025). Pregnancies have been reported after embolization. Each situation is still discussed individually with the gynaecology team according to the location of the fibroids and the pregnancy plan.

→ Full details on fibroid embolization

🩸 Fibroids and pelvic varices: relieving pain during intercourse

Dyspareunia (pain during sexual intercourse) is a common but often unspoken symptom associated with large or poorly placed uterine fibroids, as well as with pelvic congestion syndrome (internal pelvic varicose veins). In the latter case, the pain is classically more marked at the end of intercourse and may persist for several hours afterwards.

Embolization, of fibroids as well as of pelvic varices, targets the anatomical cause of the pain directly (compression by the fibroid, or congestive venous reflux), with improvement of dyspareunia reported in the majority of patients treated for these two indications.

→ Details on pelvic varices · → Pelvic congestion syndrome

💙 Erectile dysfunction: regaining erections

Some erectile dysfunction, particularly in young men with no cardiovascular risk factor, is due to a penile venous leak (cavernous venous insufficiency): blood escapes from the corpora cavernosa faster than it enters, preventing a firm erection from being maintained.

In this specific situation, targeted embolization of the abnormal veins can restore satisfactory rigidity. This technique is not suitable for all causes of erectile dysfunction (arterial, hormonal or psychogenic causes require different management), hence the importance of a precise work-up before any decision.

→ Details on penile venous leaks 🇫🇷 · → Restoring good-quality erections

❓ Frequently asked questions