Everything you need to know and do in the days leading up to your PAE procedure.
📅 Review as soon as possible
🍽️
Fasting Rules
Important — Read Carefully
Fasting Before Your Procedure
🚫 No Solid Food
8 hours before your arrival time
✅ Clear Liquids OK
Up to 2 hours before arrival
✅ Clear Liquids Include
Water · Black coffee · Plain tea · Apple juice · Broth
💊
Medications
Continue ALL medications as normal. No medications need to be stopped — wrist access means very low bleeding risk. Take morning medications with a sip of water within the clear liquid window.
Exception: Do NOT take diabetic medications (insulin or oral diabetes pills) the night before or morning of the procedure.
✅
Days Before — Checklist
Arrange an escort (18+). A responsible adult must escort you from the procedure area, drive you home, and stay with you for several hours. Car service or rideshare is not acceptable unless no sedation was given.
Plan for a couple of lighter days after the procedure — most patients resume normal activities as tolerated. Stock your home with easy-to-prepare foods. Post-procedure medications will be called in to your pharmacy at discharge — confirm your pharmacy with our team.
Notify us of any allergies to contrast dye, iodine, shellfish, or medications.
Notify us if you take a GLP-1 medication (Ozempic, Wegovy, Mounjaro, Victoza, Trulicity) or have sleep apnea — both affect sedation.
Notify us of any kidney disease. Contrast dye is used and special precautions may be needed.
Lab work is generally not required. Dr. Fischman will let you know at consultation if any is needed.
Confirm MRI or CT imaging has been sent to our team or is accessible digitally.
Checklist progress0 / 7
🌙
The Day Before
📞
Nurse Call — Afternoon
One of our nurses will call you in the afternoon on the day before your procedure to review your instructions, answer questions, and confirm your arrival time. Please keep your phone available and charged.
Eat normally during the day. Fasting begins 8 hours before your assigned arrival time.
No alcohol for at least 24 hours before your procedure.
Shower tonight or morning of. No lotions, creams, or deodorant on the wrist area.
Wear loose, comfortable clothing. Avoid tight sleeves — catheter placed through the wrist.
Leave jewelry and valuables at home.
Set up a comfortable rest area at home. Post-procedure medications will be called in to your pharmacy around the time of discharge — confirm your pharmacy name with our team.
🌅
Morning Of
No solid food within 8 hours of arrival. Clear liquids OK until 2 hours before — then nothing by mouth.
Take all regular medications with a sip of water, within the clear liquid window. Skip diabetic medications.
Where to go: 1000 10th Avenue (between W 58th & W 59th St) — 4th Floor, Interventional Radiology Registration.
Arrive at the time confirmed by our nurse the afternoon prior. Late arrival may result in rescheduling.
Bring: Photo ID · Insurance card · Medication list · Any imaging not already sent to us.
Your escort (18+) must be present and able to take you home. Car service or rideshare is not acceptable unless no sedation was given.
What to Expect
Procedure Day
A step-by-step walkthrough of your PAE procedure day.
⏱️ Plan for approximately half a day
ℹ️
What Is PAE?
PAE (Prostate Artery Embolization) treats an enlarged prostate (BPH) by reducing its blood supply, causing it to shrink over time and relieving urinary symptoms.
Dr. Fischman accesses the prostate arteries through a tiny catheter inserted at your wrist — no incisions, no general anesthesia, and most patients go home the same day.
🗓️
Your Day, Step by Step
1
Check-In & Registration
Arrive at 1000 10th Ave, 4th Floor — IR Registration. Paperwork and insurance verification completed.
2
Pre-Procedure Prep
Nurse places your IV and reviews medical history, medications, and allergies. Vital signs monitored throughout.
3
Consent
A physician (MD) or advanced practice provider (PA or NP) will review and obtain your informed consent.
4
Sedation
IV sedation keeps you relaxed and comfortable. You'll be drowsy but able to respond. No general anesthesia.
5
Wrist Access
Dr. Fischman numbs your wrist with local anesthesia and inserts a small sheath into the radial artery. Pressure — but no pain.
6
The Procedure (~1 hour)
Using live X-ray (fluoroscopy), Dr. Fischman guides a tiny catheter to the prostate arteries and delivers an embolic to reduce blood flow to the prostate.
7
Recovery (~2 hours)
You rest in recovery while vital signs and the wrist site are monitored. Most patients feel comfortable within this period.
8
Discharge & Home
IV removed, discharge instructions given, prescriptions called in to your pharmacy. Your escort takes you home.
After Your Procedure
Post-Op Instructions
What to expect during recovery and how to take care of yourself after PAE.
📆 Follow-up in 6 weeks
💡
What's Normal After PAE
Post-Embolization Syndrome
These symptoms are expected and typically improve within 4–5 days:
Fatigue, nausea, poor appetite, low-grade fever (up to 100.5°F), night sweats or chills
Pelvic pain or discomfort is common and can last 7–10 days after the procedure — this is expected as your body responds to the embolization
Urinary frequency, urgency, or hesitancy — common due to prostate inflammation, improves over weeks
Burning during urination for 7–14 days
Small amount of blood in urine — gradually improves
Blood in semen for 7–21 days — normal, not dangerous
Bruising at wrist — may take 2–3 weeks to fully resolve
🏃
Activity & Diet
Resume normal activities as tolerated. No heavy lifting (>10 lbs) for 24 hours.
Walking encouraged to promote circulation.
Ease back into strenuous exercise as you feel comfortable.
No driving for 24 hours.
Drink 8–10 glasses of water daily. No caffeine or alcohol for 48 hours.
Resume normal diet — start with small, light meals.
No baths, hot tubs, or pools for 5 days. Shower after 24 hours.
Avoid sexual activity for 5–7 days.
💊
Medications
⏱️ Start Here — When to Begin
TONIGHTStart your Pyridium and pain medication when you get home.
TOMORROWStart your Medrol dose pack and your oral antibiotic the morning after your procedure.
AFTER TAPERStart meloxicam only after the Medrol pack is completely finished — not at the same time.
Pyridium (phenazopyridine)
Start tonight for urinary burning. Take as directed by Dr. Fischman. Your urine will turn bright orange — this is harmless. It can also permanently stain contact lenses, so wear glasses instead while taking it.
Pain medicationas needed
Acetaminophen (Tylenol) as needed for discomfort. Do not exceed the recommended dose. Avoid ibuprofen and other NSAIDs — you will be starting a steroid tomorrow.
Colaceas needed
Stool softener. Start tonight if desired — constipation is common from pain meds and reduced activity.
💉
Antibiotics given during your procedure
You received antibiotics through your IV during the procedure. Your oral antibiotic starts tomorrow morning — not tonight.
Medrol Dose Packwith food
Start the morning after your procedure. Follow the tapering schedule printed on the pack exactly — do not stop abruptly.
Oral Antibioticwith food
Bactrim or Ciprofloxacin. Start this morning and complete the full course.
Pyridium (phenazopyridine)
Continue as directed by Dr. Fischman for urinary burning. Urine stays bright orange while taking it — harmless. Keep wearing glasses, not contacts.
Acetaminophen + Colaceas needed
Use acetaminophen (Tylenol) for breakthrough pain while on the steroid. Do not take ibuprofen or other NSAIDs during the Medrol taper — combining them raises the risk of stomach bleeding. Continue Colace as needed.
🚫
Do not start meloxicam yet
Wait until the Medrol pack is completely finished before starting meloxicam. Taking them together increases the risk of stomach irritation and bleeding.
Meloxicamwith food
Start only after the Medrol pack is completely finished. Anti-inflammatory that helps with ongoing discomfort. Take with food.
Colaceas needed
Continue as needed while taking pain medication.
Only if prescribed to you
💊 Valium (diazepam)if prescribed
Some patients receive Valium to help with sleep or muscle relaxation. If it was prescribed to you, take as directed at night. Do not drive after taking it, and do not combine with other sedatives or alcohol.
💊 Vesicare (solifenacin)if prescribed
Prescribed for some patients who have significant bladder spasms after the procedure. If it was prescribed to you, take as directed. May cause dry mouth or constipation.
💊
Keep Taking Your Prostate Medications
Continue your usual prostate medications (such as Cialis, Flomax, finasteride, etc.) as normal. Do not stop them on your own. Dr. Fischman will review them at your 6-week follow-up and adjust as needed.
⚠️
Blood Thinners
Please ask us about blood thinners (aspirin, Plavix, Eliquis, Xarelto, etc.) — we will advise you on when and whether to resume them.
😴 Trouble Sleeping
Difficulty sleeping during the first week is common. If it becomes a problem, contact us and we can send a sleep medication to your pharmacy.
🚨
When to Seek Help
Call Us
Fever >101°F (38.5°C) or persistent chills
Inability to urinate despite medications
Significant increase in blood in urine
Worsening pelvic pain not controlled by medications
Redness, swelling, or discharge at wrist site
Leg or ankle swelling
Call 9-1-1 or Go to ER
Uncontrolled bleeding from wrist that won't stop with 15 min of pressure
Pain, numbness, coolness, or blue discoloration of the hand/wrist
Chest pain or sudden shortness of breath
Severe allergic reaction: hives, throat tightening, face swelling
High fever >103°F with severe shaking
Loss of consciousness or extreme confusion
📆
Follow-Up
🗓️ 6 Weeks
Follow-up appointment to review symptoms and assess recovery.
🗓️ 6–9 Months
MRI of the prostate to evaluate size reduction and confirm effectiveness.
Get in Touch
Contact Us
Tap any number to call directly. We're here before and after your procedure.