TURP vs PAE: Which Is Better for Enlarged Prostate (BPH) Treatment?

Introduction: Old Gold Standard vs Modern Innovation

For decades, if medicines failed to control urinary symptoms of an enlarged prostate (BPH), the automatic recommendation was TURP (Transurethral Resection of Prostate) — a surgical procedure that physically removes prostate tissue.

But now, a new option — PAE (Prostate Artery Embolization) — is available in advanced centres in India. It’s a minimally invasive procedure performed by interventional radiologists, offering a safer, quicker recovery with fewer side effects.

So which is better for you or your loved one — TURP or PAE? Let’s compare them side by side.

What Is TURP?

TURP has long been the “gold standard” surgery for BPH. It involves:

• A surgeon inserting a resectoscope through the urethra.
• Using an electrical loop to shave away parts of the enlarged prostate.
• Removing tissue that blocks urine flow.

📌 Quick facts:

• Requires spinal or general anesthesia.
• Patient usually stays in hospital for 2–3 days.
• A catheter is kept for 3–5 days post-surgery.

⚠️ Risks & Side Effects:

• 5% risk of erectile dysfunction.
• 6% risk of urethral stricture (scarring).
• 7% risk of permanent incontinence.
• Bleeding and hospitalisation.

What Is PAE (Prostate Artery Embolization)?

PAE is a revolutionary, minimally invasive procedure performed by an interventional radiologist (IR):

• A thin catheter is inserted into the femoral or radial artery.
• Guided under X-ray, the IR reaches arteries supplying the prostate.
• Tiny beads (microspheres) are injected to block blood flow to the prostate.
• Over time, the prostate shrinks, relieving symptoms.

📌 Quick facts:

• Done under local anesthesia only.
• Day-care procedure — discharge same day.
• Usually no catheter required.
• Minimal pain, quick recovery.

⚠️ Limitations:

• Not suitable if there’s a large median lobe obstructing bladder.
• Requires advanced centres and highly skilled IRs.

TURP vs PAE: A Side-by-Side Comparison

Patient Experience – What It Feels Like

After TURP

• Hospital admission for 2–3 nights.
• Discomfort due to catheter for 3–5 days.
• Burning while passing urine for weeks.
• Blood in urine common for first 1–2 weeks.
• Full recovery takes 3–4 weeks.

After PAE

• Walk into hospital in the morning, walk out in evening.
• Local anesthesia — patient awake, no memory loss.
• Small bandage at groin/wrist, no surgical cut.
• Usually catheter not required.
• Resume work in 2–3 days.

Cost Comparison in Mumbai

• TURP cost: ₹1.5–1.8 lakh at good multispeciality hospitals. Cheaper in small nursing homes (₹60K–1 lakh) but much higher complication risk.
• PAE cost: ₹2.7–3 lakh. Covered by most major insurance companies (cashless & reimbursement).

📌 Key point: While PAE costs more upfront, the long-term quality-of-life benefits and insurance coverage make it highly worthwhile.

Risks & Complications – The Honest Truth

TURP Risks

• Erectile dysfunction (~5%)
• Urethral stricture (~6%)
• Permanent incontinence (~7%)
• Retrograde ejaculation (~65–70%)
• Higher risks in smaller clinics

PAE Risks

• Minor bruising at catheter site
• Temporary urinary frequency post-procedure
• Rare complications if non-target artery is blocked (avoided with skilled IRs)
• Almost zero risk of erectile dysfunction or incontinence

Which Patients Benefit Most from PAE?

• Men who want to avoid anesthesia.
• Men with high surgical risk (heart/lung disease, diabetes).
• Men who don’t want catheterisation or long hospital stay.
• Men concerned about sexual side effects.

Which Patients Still Need TURP?

• Men with very large median lobe obstructing bladder.
• Patients with bladder stones + BPH (need simultaneous surgery).
• Cases where insurance doesn’t cover PAE and affordability is an issue.

FAQs – TURP vs PAE

Q1. Which lasts longer — TURP or PAE?
Both are durable. TURP has 30+ years of data. PAE has 10+ years of evidence and results look equally strong.

Q2. Does PAE cure BPH?
It shrinks the prostate permanently in most cases. But some may need retreatment years later (just like TURP).

Q3. Is PAE painful?
No — done under local anesthesia, with minimal discomfort.

Q4. Which has fewer side effects?
PAE — far lower risk of sexual or urinary complications.

Conclusion: The Verdict

Both TURP and PAE are effective treatments for enlarged prostate (BPH).

• TURP remains a solid choice, but comes with hospitalisation, anesthesia, and higher risk of complications.
• PAE is the modern, patient-friendly alternative — same-day procedure, no catheter, faster recovery, almost no risk to sexual function.

At Docsy, we offer both clarity and choice:

• Free OPD + ultrasound in Mumbai (Chembur, Pune)
• Free teleconsultation with Care Navigator & senior urologists
• Access to world-class PAE centres with experienced interventional radiologists