Prostate Artery Embolization (PAE) in San Antonio, TX

Advanced, Minimally Invasive Treatment for Enlarged Prostate

If you're dealing with frequent urination, a weak stream, or waking up multiple times at night, you may be experiencing symptoms of benign prostatic hyperplasia (BPH), a common condition as men age.

At The Urology Place, we offer Prostate Artery Embolization (PAE), a non-surgical, outpatient treatment designed to shrink the prostate and relieve symptoms without the risks of traditional surgery.

What Is PAE?

Prostate Artery Embolization (PAE) is a minimally invasive procedure used to treat symptoms of an enlarged prostate (also called benign prostatic hyperplasia, or BPH). During the procedure, a specially trained doctor threads a tiny catheter through a small puncture in the wrist or groin and uses X-ray guidance to reach the blood vessels feeding the prostate. Tiny particles are then injected to reduce blood flow to the prostate, causing it to shrink over time. This relieves urinary symptoms without traditional surgery.

PAE is typically performed as an outpatient procedure, meaning most patients go home the same day.

Peaceful outdoor setting suggesting recovery and quality of life

What Does the Research Say?

Below is a summary of four major studies that have evaluated PAE. Together, they include over 1,400 patients and provide strong evidence that PAE is safe and effective.

Does PAE Really Work, or Is It Just a Placebo Effect?

The Study: A randomized, placebo-controlled trial published in European Urology (2020) — one of the world’s top urology journals.

What They Did: 80 men with severe BPH symptoms that had not improved with medication were randomly assigned to receive either a real PAE procedure or a “sham” (fake) procedure. Neither the patients nor the evaluators knew which procedure each patient received.

Key Findings:

Men who received PAE had dramatically better symptom improvement than those who received the sham procedure.
Quality of life scores were also significantly better in the PAE group.
When the sham group later received the real PAE procedure, they experienced the same level of improvement.
Side effects were similar between both groups, and no serious complications occurred.

What This Means for You: This study proves that the benefits of PAE are real — not just a placebo effect. This is considered the gold standard type of clinical trial.

How Well Does PAE Work Over the Long Term?

The Study: The largest single-center PAE study ever published, including 1,075 patients, published in the Journal of Vascular and Interventional Radiology (2025).

What They Did: Researchers tracked patients for up to 5 years after PAE, measuring symptom scores, quality of life, medication use, and complications.

Key Findings:

Symptom scores dropped significantly within the first few months and remained improved for up to 5 years.
Quality of life improved substantially and was maintained long-term.
94% of patients who needed a urinary catheter before the procedure were catheter-free within 3 months.
65.5% of patients were able to stop their BPH medications within 1 year.
Only 16% of patients needed a second prostate procedure over 5 years.
Serious side effects were very rare (less than 1%), and all resolved completely.

What This Means for You: PAE provides lasting symptom relief for the vast majority of patients, with a very favorable safety profile.

Is PAE Better Than Taking Medication?

The Study: The P-EASY ADVANCE randomized controlled trial, published in BJU International (2024).

What They Did: 39 men who had never been treated for BPH were randomly assigned to receive either PAE or combination medication therapy (tamsulosin + dutasteride — two of the most commonly prescribed BPH drugs).

Key Findings:

PAE was more effective than medication at relieving urinary obstruction: 63% of PAE patients were unobstructed vs. only 28% on medication.
PAE patients had greater reductions in prostate size, symptom scores, and better quality of life.
Medication side effects — including altered ejaculation, erectile dysfunction, and nausea — were more common in the medication group.

What This Means for You: For men just starting treatment for BPH, PAE may be a more effective option than medication, with fewer sexual side effects.

How Does PAE Compare to Traditional Prostate Surgery (TURP)?

The Study: The UK-ROPE study, a large multicenter registry published in BJU International (2018), comparing 216 PAE patients to 89 TURP patients across 17 UK medical centers.

Key Findings:

PAE produced a clinically meaningful 10-point improvement in symptom scores at 12 months.
TURP produced a slightly larger improvement (15 points), but PAE offered important practical advantages:

71% of PAE patients went home the same day, compared to only 20% of TURP patients.
PAE had a lower complication rate.
PAE patients returned to normal activities faster.
PAE does not carry the risk of retrograde ejaculation (a common side effect of TURP).

What This Means for You: While traditional surgery (TURP) may produce slightly greater symptom improvement, PAE offers a less invasive alternative with fewer complications, a faster recovery, and the ability to go home the same day.

Is PAE Recommended by Medical Societies?

Yes. The American Urological Association (AUA) — the leading professional organization for urologists in the United States — includes PAE as a recommended treatment option for men with prostates 50 cc or larger in their 2026 clinical guidelines.

Quick Comparison

Comparison of PAE, medication, and TURP surgery for BPH
Category	PAE	Medication	TURP (Surgery)
Procedure	Minimally invasive (tiny wrist/groin puncture)	Daily pills	Surgery under anesthesia
Recovery	Same day; return to activities in days	No recovery needed	1–2 nights in hospital; weeks to recover
Effectiveness	Significant and lasting	Moderate	Greatest improvement
Risks / Side Effects	Very low risk	Common (erectile dysfunction, ejaculation changes)	Common (retrograde ejaculation)
Catheter	Usually not	N/A	Typically yes, for days
Retreatment	~16% over 5 years	Ongoing daily use	~10–15% over time

Is PAE Right for You?

PAE may be a good option if you:

Have moderate to severe urinary symptoms from an enlarged prostate
Have not found adequate relief from medications
Want to avoid traditional surgery
Are concerned about sexual side effects
Prefer a same-day, minimally invasive procedure

The best way to find out if PAE is right for you is to schedule a consultation. We will review your symptoms, medical history, and imaging to determine whether you are a good candidate.

How the Procedure Works

A small catheter is inserted through the wrist or groin and guided to the prostate arteries using advanced imaging.

Tiny particles are then injected to reduce blood flow, allowing the prostate to gradually shrink. The procedure typically takes 1 to 2 hours, is performed in an outpatient setting, and uses local anesthesia with light sedation.

This illustration shows the PAE procedure itself and helps visualize how targeted treatment is delivered to the prostate.

Illustration of the prostate artery embolization procedure

Your PAE Care Team

At The Urology Place, Dr. Naveen Kella evaluates your symptoms, confirms whether PAE is appropriate, and coordinates your overall BPH care. The embolization procedure is performed by Dr. Sandeep Rao, a board-certified interventional radiologist who works closely with Dr. Kella to deliver image-guided, minimally invasive treatment.

Dr. Sandeep Rao, interventional radiologist

Dr. Sandeep Rao, MD, MBA, CWSP

Board-Certified Interventional Radiologist

With more than two decades in practice, Dr. Rao focuses on minimally invasive, image-guided treatments for vascular disease, chronic pain, and other complex conditions.

His expertise includes prostate artery embolization for enlarged prostate, along with genicular artery embolization for knee pain and plantar fascia embolization. He is known for adopting newer endovascular techniques early in their clinical use.

Dr. Rao performs hundreds of embolization procedures each year and partners with Dr. Kella so patients receive thorough urologic evaluation before and coordinated follow-up after PAE.

- Medical Degree: Texas Tech University Health Sciences Center
- Radiology Residency: Ohio State University
- Vascular & Interventional Radiology Fellowship: Johns Hopkins Hospital
- General Surgery Residency: Harvard Medical School (Beth Israel Deaconess Medical Center)
- American Board of Radiology – Diagnostic Radiology
- American Board of Radiology – Vascular & Interventional Radiology
- American Board of Wound Management – Certified Wound Specialist Physician
Dr. Rao performs a wide range of advanced procedures, including:
Prostate Artery Embolization (PAE)
Genicular Artery Embolization (GAE) for knee pain
Plantar Fascia Embolization
Hemorrhoid Embolization
Varicocele Embolization
Peripheral artery disease treatments
Venous disease treatments
He completes hundreds of embolization procedures each year and regularly presents at national interventional radiology conferences.

Recovery and Results

Most patients go home the same day. You may experience mild pelvic discomfort for a few days along with temporary urinary urgency or frequency. Most individuals are able to return to normal activities within 1 to 3 days. Symptom improvement typically begins within a few weeks and continues to improve over the course of 2 to 3 months.

Scheduling Information

To schedule your consultation with Dr. Kella: Please call 210-617-3670 and ask to speak with the PAE scheduling team, or select the surgery line when prompted. If the department is unavailable, please dial extension 107, 103, or leave a voicemail.

Procedure Location

To schedule the PAE procedure with Dr. Rao: Please contact Monica at 210-660-2010.

I-Vascular Center
19234 Stonehue
San Antonio, TX 78258

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