Patient guide
Blood in your urine from an enlarged prostate? How PAE can help stop the bleeding
Passing blood because of an enlarged prostate, even when blood thinners are part of the picture? In a small study, prostate artery embolization (PAE) stopped the bleeding in every man by 3 months. Why checks come first, and who it may suit.
Why men who bleed from the prostate look at PAE
- Bleeding stopped in 12 of 12 menWithin 3 months, in a small study
- No cuttingTreated from the arteries
- Local anaesthesiaUsually no general anaesthetic
- Still worked on blood thinnersSuccess continued in men who needed them later
First, find out where the blood is coming from
Seeing blood in your urine is frightening, and it should never be ignored. It can come from the kidneys, the bladder, the prostate or the urine pipe. Stones, infection, bladder tumours and prostate cancer can all cause it.
That is why the first step is always a proper check: a urine test, an ultrasound or CT of the kidneys and bladder, a PSA blood test, and usually a camera test of the bladder (cystoscopy). In the study below, every man had imaging and cystoscopy to rule out other causes before PAE was considered [1]. Only when the enlarged prostate itself is the source does PAE become an option.
How an enlarged prostate causes bleeding
As the prostate grows, it grows many fragile blood vessels, especially along the inside of the urine pipe. They can burst on their own, often when you strain or are on blood thinners. Tablets can help, and some men need an operation. PAE gives another route: it closes off the small arteries feeding the prostate, so there is less blood to bleed.
What a study of men who were passing blood found
A study treated 12 men who were passing visible blood because of an enlarged prostate, after other causes had been ruled out. The study is small, so it is a good sign and not a guarantee.
| What was measured | What happened |
|---|---|
| Procedure was completed | 12 of 12 men (100%), on both sides |
| Bleeding stopped by 3 months | All 12 men (100%) |
| Still bleed-free at 18 months | 11 of 12 men (92%) |
| The one man whose bleeding returned | He had been given too much blood thinner. It stopped once that was corrected. |
| Sexual function | No sexual dysfunction was reported. Symptom, quality-of-life and erection scores improved. |
What about blood thinners?
Many men with prostate bleeding also take blood thinners for the heart or for clots, and they worry that nothing can be done. In this study, the benefit continued even when a man was later put on blood thinners [1]. That does not mean blood thinners are risk-free. We plan around your medicines, and we do not stop or change them without your own doctor.
Where PAE fits for prostate bleeding
A 2026 review of PAE says it is increasingly used for stubborn prostate bleeding, whether it comes from an enlarged prostate, a cancer, or an earlier procedure. It reports high technical success and real control of bleeding, and describes PAE as useful in men who are poor candidates for surgery or whose bleeding came back after surgery through the urine pipe. It also states that evidence for PAE for blood in the semen is limited to small case series and is still investigational [2].
In other words: for bleeding that comes from the prostate and cannot be controlled in other ways, PAE is a serious option. It is not a first step, and it is not for bleeding whose cause has not been found.
What we check at the consultation
Bring everything you have, and we will go through it together:
- Your urine tests, ultrasound or CT, PSA, and the report of any cystoscopy
- Your medicines, especially blood thinners, and why you take them
- Your prostate size and the other symptoms you have, such as a weak stream or night trips
- What else has been tried, and what you would like to avoid
Check your urine symptoms too
Many men who pass blood from the prostate also have a weak stream or get up at night. Our free prostate symptom score takes about two minutes, and you can send the result to our team.
Frequently asked questions
- Can an enlarged prostate cause blood in the urine?
- Yes, it can. But blood in the urine can also come from the kidneys, bladder, or a cancer, so you need scans and a camera test of the bladder before it is blamed on the prostate [1].
- Can PAE stop bleeding from an enlarged prostate?
- In a small study of 12 men the procedure was completed in all of them, and the bleeding had stopped in every one of them by 3 months, with 92% still bleed-free at 18 months [1]. Larger studies are needed, and we check whether it suits you first.
- I take blood thinners. Can I still have PAE?
- This is decided case by case. In the study, benefit continued even when a man was later put on blood thinners [1], but we plan around your medicines and your own doctor stays in charge of them.
- Is PAE the first treatment for prostate bleeding?
- No. First the cause must be found, and tablets are tried when suitable. PAE is a serious option when the bleeding comes from the prostate and has not been controlled in other ways, and for men who are poor candidates for surgery [2].
- Where can I discuss this in Hyderabad?
- Dr. Nagateja Bonala offers prostate artery embolization at Clinic Seven. Bring your scans, PSA, cystoscopy report and medicine list to the consultation.
Check your prostate symptom score
References
- Tapping CR, et al. Prostatic Artery Embolization (PAE) for Benign Prostatic Hyperplasia (BPH) with Haematuria in the Absence of an Upper Urinary Tract Pathology. Cardiovasc Intervent Radiol. 2018. Read the source
- Tawfellos G, et al. Prostatic Artery Embolization: A Contemporary Review of Efficacy, Safety, and Expanding Clinical Indications. Curr Urol Rep. 2026. Read the source
Want to discuss your options?
Speak with the Clinic Seven team.