June 9, 2025
A Comparison of Two Common Treatments for Enlarged Prostate
If you're experiencing the uncomfortable symptoms of an enlarged prostate — like frequent urination, a weak stream, or waking up several times a night — you're not alone. These symptoms are typically caused by benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate that affects most men as they age.
Two of the most common treatment options for BPH are:
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Prostate Artery Embolisation (PAE) – a minimally invasive, image-guided procedure performed by an interventional radiologist
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Transurethral Resection of the Prostate (TURP) – a surgical procedure performed by a urologist
Both can offer significant relief — but they differ in approach, recovery, and side effects. So which one is right for you?
Let’s break it down.
What is TURP?
TURP is often considered the “gold standard” for treating BPH. It involves inserting a scope through the urethra and surgically removing part of the prostate tissue that is blocking urine flow.
TURP Pros:
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Proven long-term results
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Immediate symptom relief for many patients
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Widely available through urologists
TURP Cons:
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Requires general or spinal anaesthesia
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Typically involves a hospital stay and catheterisation
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Recovery time is usually 4–6 weeks
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Higher risk of complications such as:
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Bleeding
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Infection
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Retrograde ejaculation (semen goes into the bladder)
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Erectile dysfunction in some cases
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What is PAE?
PAE is a non-surgical procedure performed by an interventional radiologist. It involves inserting a tiny catheter into the arteries that supply the prostate and injecting microscopic particles to reduce blood flow, causing the prostate to shrink over time.
PAE Pros:
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Minimally invasive (no cutting, no scope through the urethra)
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Performed under local anaesthetic
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Typically a same-day procedure
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Shorter recovery (most men resume light activity within a few days)
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Low risk of sexual side effects
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Suitable for men who are not candidates for surgery
PAE Cons:
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Slightly slower symptom relief (gradual improvement over several weeks)
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Not suitable for everyone — depends on prostate anatomy and size
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May not be as effective in extremely large prostates
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Still considered an emerging treatment in some centres (less availability)
How Do the Results Compare?
| Feature | TURP | PAE |
|---|---|---|
| Invasiveness | Surgical | Minimally invasive |
| Anaesthesia | General or spinal | Local |
| Hospital stay | 1–2 nights | Usually none (day procedure) |
| Catheter required? | Yes (2–3 days) | Sometimes (short-term) |
| Recovery time | 4–6 weeks | Few days to 1 week |
| Symptom relief | Fast | Gradual over several weeks |
| Sexual side effects | More common | Rare |
| Repeat procedure needed? | Less common | Possible in future |
Who is a Good Candidate for Each?
TURP may be better for:
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Men with severely enlarged prostates
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Those needing fast relief from significant symptoms
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Individuals with urinary retention or complications from BPH
PAE may be better for:
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Men wanting to avoid surgery or general anaesthetic
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Those who are not fit for surgery due to other health conditions
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Men who are concerned about preserving sexual function
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Patients with moderate to severe symptoms looking for a lower-risk option
So… Which One is Better?
There’s no one-size-fits-all answer. Both PAE and TURP can offer excellent outcomes — it depends on your specific health, symptoms, preferences, and goals.
If you’re unsure which option is right for you, speak with both a urologist and an interventional radiologist. Together, we can assess your prostate health, review imaging, and guide you toward the safest and most effective treatment for your needs.
