Enlarged prostate care in Orange County
How Orange County men can sort through medication, office-based procedures and prostate artery embolization, and how an evaluation works at our Fountain Valley office.
Editorially updated October 14, 2026. This educational page was prepared by SoCal Interventional using the cited primary and authoritative sources. It does not replace an individualized medical evaluation.
Quick answer: “Non-surgical” treatment for an enlarged prostate (benign prostatic hyperplasia, BPH) covers four tiers: watchful waiting and lifestyle changes, daily medication, minimally invasive office or outpatient procedures, and prostate artery embolization (PAE), an image-guided catheter procedure performed by an interventional radiologist. Orange County patients can be evaluated for PAE, and for whether another option fits better, at the SoCal Interventional office at 10900 Warner Avenue, Suite 101A, Fountain Valley, CA 92708. Call (310) 929-0026 or request an evaluation.
This page is written for men in Fountain Valley, Huntington Beach, Costa Mesa, Newport Beach, Irvine, Santa Ana, Garden Grove, Westminster, Tustin, Orange, Anaheim and south Orange County who have urinary symptoms and want to understand the options before, or instead of, surgery. For the procedure itself, read our complete prostate artery embolization guide; for the Orange County office, see PAE in Fountain Valley.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that BPH affects 5% to 6% of men ages 40 to 64 and 29% to 33% of men 65 and older, and calls it the most common prostate problem in men over 50. Typical symptoms are trouble starting a stream or emptying the bladder, a weak or interrupted stream or dribbling at the end, waking at night to urinate (nocturia), urgency, frequency and, less often, pain with urination.
Symptoms alone do not prove the prostate is the cause. Infection, bladder dysfunction, urethral narrowing, medications, neurologic conditions and prostate cancer can produce the same complaints, which is why every treatment path starts with a diagnosis rather than a procedure. Our BPH symptoms guide explains the warning signs in more detail.
“Non-surgical” means the prostate is treated without an incision: watchful waiting, daily medication, office procedures done through the urethra such as UroLift and Rezum, and prostate artery embolization, which reaches the prostate through an artery. It does not mean risk-free; each tier trades speed and size of relief against invasiveness and recovery time.
NIDDK groups BPH care into watchful waiting, medicines, minimally invasive surgical therapies (MIST) and surgery. Prostate artery embolization sits outside that list because it is performed through an artery, not through the urethra, by an interventional radiologist rather than a urologist. “Non-surgical” does not mean risk-free or automatically better; it means no incision and, for most options, no general anesthesia and a shorter recovery. The right choice depends on prostate size and shape, how much the bladder is obstructed, whether you have had retention, bleeding risk, sexual-function priorities and how quickly you need relief.
Watchful waiting suits mild symptoms; medication helps many men but must be taken indefinitely; UroLift and Rezum are office procedures limited by prostate size and shape; PAE treats even very large prostates through an artery with same-day discharge; transurethral and laser surgery give the largest flow improvement at the cost of anesthesia, a catheter and a longer recovery.
| Option | What it is | Where it is usually done | What the sources say |
|---|---|---|---|
| Watchful waiting and lifestyle | Timing fluids, limiting alcohol and caffeine, staying active, emptying the bladder fully and reviewing medicines that worsen symptoms | At home, with periodic follow-up | NIDDK lists these steps as the first tier for milder symptoms without complications |
| Medication | Alpha blockers, 5-alpha reductase inhibitors (5-ARIs) and phosphodiesterase-5 inhibitors, alone or combined | Prescribed by a urologist or primary-care physician | NIDDK notes a combination of an alpha blocker and a 5-ARI “may work better than one medicine alone”; medicines must be taken indefinitely and have their own side effects |
| Prostatic urethral lift (UroLift) and water-vapor therapy (Rezum) | Office or outpatient procedures done through the urethra that hold open or shrink obstructing tissue | Urology office or outpatient center | Both are listed by NIDDK as minimally invasive surgical therapies; suitability depends on prostate size and anatomy |
| Prostate artery embolization (PAE) | A catheter is guided through a wrist or groin artery and tiny particles reduce blood flow to the enlarged tissue, which shrinks gradually over weeks to months | Outpatient interventional radiology suite; our Orange County patients are treated through the Fountain Valley office | The American Urological Association’s 2026 BPH guideline strengthened its PAE statement to Grade B evidence for prostates of 50 cc or more, with the procedure performed by an interventional radiologist (reported by the Society of Interventional Radiology, June 18, 2026) |
| Transurethral or laser surgery (TURP, HoLEP, GreenLight, Aquablation) | Tissue is removed or vaporized through the urethra under anesthesia | Hospital or surgery center, often with an overnight stay and a catheter | NIDDK lists transurethral resection, laser surgery, electrovaporization and robotic surgery as the surgical tier; these give the largest flow improvement in the trials below |
For a procedure-by-procedure comparison, read PAE vs UroLift, Rezum and Aquablation and PAE vs TURP.
The Swiss randomized trial and the UK-ROPE registry agree: PAE improves symptom scores in the same range as TURP with fewer complications and no hospital stay, while TURP produces a larger gain in urinary flow and a lower re-treatment rate (5% after PAE versus 3.4% after TURP within 12 months in UK-ROPE).
Two sources are quoted most often when Orange County urologists and interventional radiologists discuss PAE against the surgical standard, TURP.
Swiss randomized trial (Abt et al., BMJ 2018). 103 men were randomized to PAE or TURP; 48 and 51 reached the 12-week primary endpoint. The International Prostate Symptom Score (IPSS, 0 to 35, lower is better) fell by 9.23 points after PAE and 10.77 points after TURP, a difference of 1.54 points in favor of TURP (95% confidence interval −1.45 to 4.52), so symptom relief was similar. Peak urinary flow improved by 5.19 mL/s after PAE versus 15.34 mL/s after TURP, a clear advantage for surgery on that measure. Fewer adverse events occurred after PAE than after TURP (36 versus 70 events, P=0.003). The authors concluded that PAE “is associated with fewer complications than TURP but has disadvantages regarding functional outcomes” and asked for longer follow-up before it is considered routine.
UK-ROPE registry (Ray et al., BJU International 2018). Across 318 men at UK centers, 216 had PAE and 102 had resection (89 TURP, 13 HoLEP). At 12 months the median IPSS improvement was 10 points after PAE and 15 after TURP. Peak flow rose from a median 8.8 to 14.1 mL/s after PAE and from 10.4 to 22.3 mL/s after TURP. Within 12 months, 5% of PAE patients needed a further procedure, rising to 11.6% when operations planned after 12 months are counted, compared with 3.4% after TURP. The median hospital stay was zero days after PAE and two days after TURP. The investigators noted that all but two centers were still learning the technique during recruitment and called PAE “a difficult procedure with a clear learning curve,” which is why operator experience belongs on your list of questions.
Read together, the two studies describe a consistent trade-off: PAE delivers symptom relief in the same range as surgery with fewer complications and a same-day discharge, while TURP produces a larger improvement in urinary flow and a lower re-treatment rate. Neither study promises an outcome for any individual, and some men who choose PAE will need another procedure later.
Orange County patients are seen at 10900 Warner Avenue, Suite 101A, inside the Pacific Coast Multi Specialty Surgery building in Fountain Valley, Monday through Friday, 8 AM to 5 PM. The office is off the I-405 at Warner Avenue, about 15 minutes from Irvine, and serves the same communities our former Irvine office did. Dr. Nathanael Sabbah, the interventional radiologist who performs PAE for the practice, conducts the evaluation.
NIDDK advises telling a health care professional right away if you cannot urinate at all, have painful, frequent or urgent urination with fever and chills, see blood in your urine, or have severe pain in the lower abdomen or urinary tract. Complete retention is an emergency: go to the nearest Orange County emergency department rather than waiting for a consultation. Men who are catheter-dependent after an episode of retention can still be evaluated for PAE once they are stable.
SoCal Interventional accepts most PPO plans, Medicare, self-pay and some IPA plans, subject to individual coverage and authorization. Coverage for PAE depends on the plan, medical necessity, provider participation and prior-authorization rules, so benefits are verified before any procedure is scheduled. Our PAE cost and insurance page explains what the office checks and what to ask your plan. HMO patients usually need a referral from their primary-care physician or medical group.
Before choosing any BPH treatment, ask about your prostate volume, whether bladder function has been tested, the physician’s annual case volume, the published re-treatment rate, whether you will need anesthesia or a catheter, the likely sexual side effects, and whether your PSA has been addressed. The answers show whether the option fits your anatomy and whether the provider has the experience to deliver it.
Comparing physicians or offices? How to choose a PAE doctor lists what to verify before scheduling and compares our Van Nuys, Tarzana and Fountain Valley locations.
Yes. SoCal Interventional evaluates and treats Orange County patients for PAE through its Fountain Valley office at 10900 Warner Avenue, Suite 101A. Confirm the location when you schedule.
Not always, but most patients already have one. The evaluation reviews your urology records and PSA history, and an elevated PSA or incomplete cancer workup is addressed with a urologist before any BPH procedure is planned.
NIDDK lists watchful waiting, alpha blockers, 5-alpha reductase inhibitors, phosphodiesterase-5 inhibitors, prostatic urethral lift and water-vapor therapy. The American Urological Association’s 2026 guideline gives PAE a Grade B evidence rating for prostates of 50 cc or more when performed by an interventional radiologist.
In the 2018 Swiss randomized trial, symptom-score improvement was similar (9.23 versus 10.77 points) while flow improvement was larger after TURP (5.19 versus 15.34 mL/s) and adverse events were fewer after PAE (36 versus 70). The UK-ROPE registry reported a median hospital stay of zero days after PAE versus two after TURP and a 12-month re-treatment rate of 5% after PAE.
Usually, yes. Do not stop a prescribed medication on your own; bring the list to the evaluation and the team will discuss what to continue, pause or change around any procedure.
To Fountain Valley. The Warner Avenue office is about 15 minutes from Irvine via the I-405, with the same physician and the same phone number, (310) 929-0026.
Call (310) 929-0026 or request a BPH evaluation in Orange County. Consultations and procedures take place at our Fountain Valley office on Warner Avenue; learn more about interventional radiology in Fountain Valley and the other conditions treated there.
Medical disclaimer: This page provides general education and cannot determine individual candidacy or outcome. Figures quoted from studies describe groups of patients, not any individual result.
Explore more: Read the complete prostate artery embolization treatment guide, our overview of BPH treatment options at all three offices, the PAE Patient Resource Center, and our Medical Editorial Policy.
Medical content reviewed by Nathanael Sabbah, MD, interventional radiologist. Last reviewed: October 2026.