California Urologists Raise Awareness of PAE for Enlarged Prostate

Medically reviewed by Dr. Theodore Bryan, MD, Interventional Radiology · Last updated September 2026

Dr. Lamia Gabal and Dr. Hari Sawkar are raising awareness of prostate artery embolization (PAE) as a minimally invasive option for men living with an enlarged prostate — one that many patients don’t realize exists alongside medication and traditional surgery.

Most men think their only options are medication or surgery

Benign prostatic hyperplasia (BPH) — a non-cancerous enlargement of the prostate — is common as men age, and it can bring frequent urination, nighttime bathroom trips, urinary urgency, a weak stream, and a nagging sense of never fully emptying the bladder. Left unaddressed, these symptoms chip away at sleep, travel, and everyday routine.

The trouble is, many men don’t realize how many options actually exist between “wait it out on medication” and “have surgery.” A full urologic evaluation is what actually reveals the full menu — including PAE, a minimally invasive treatment that’s been gaining attention as more patients look for effective relief without an incision or a long recovery.

What makes PAE different

PAE is an image-guided procedure performed by an interventional radiologist. A small catheter is guided into the arteries supplying blood to the prostate, where microscopic particles are delivered to reduce that blood flow — allowing the enlarged tissue to gradually shrink and ease pressure on the urinary tract. There’s no open surgical incision, and it’s typically done on an outpatient basis, often with a shorter recovery than traditional prostate surgery for appropriately selected patients.

The American Urological Association recognizes PAE as an appropriate option for lower urinary tract symptoms associated with BPH, when it’s performed by properly trained physicians and discussed thoroughly with the patient beforehand — which is exactly the kind of evaluation our practice builds every treatment plan around.

Why evaluation comes before any treatment decision

Urinary symptoms can come from more than one underlying cause, which is why treatment at our practice never starts with a procedure — it starts with a comprehensive evaluation covering symptoms, prostate size, medical history, and what actually matters most to the patient.

“Choosing the right treatment requires more than identifying an enlarged prostate. Our collaborative approach allows us to evaluate the whole patient and provide an individualized recommendation based on his health, symptoms, anatomy, and personal priorities.” — Dr. Lamia Gabal, MD, FPMRS

That evaluation is led by Dr. Gabal and Dr. Sawkar, who bring more than three decades of combined urologic experience between them. When PAE is the right fit, care is coordinated with Dr. Theodore Bryan, a dual board-certified interventional radiologist with clinical and published research experience specifically in prostate artery embolization — so the procedure itself is in the hands of a specialist focused on exactly this technique.

A coordinated team, not a single procedure

What’s distinct about this approach isn’t just the availability of PAE — it’s the coordination behind it. Rather than a patient having to find and connect a urologist and an interventional radiologist on their own, our practice brings that collaboration in-house, with a urology team leading evaluation and treatment planning, and PAE performed by a specialist within that same coordinated care model.

This article is for general educational purposes and isn’t a substitute for medical advice. Candidacy for any BPH treatment, including PAE, is determined through an in-person evaluation.