I am happy to announce that I have now partnered with Halo Precision Diagnostics to offer MRI-guided transurethral whole (or partial) gland ablations for prostate cancer using the TULSA device, developed by Profound Medical. This technique was recently featured on the cover of the Journal of Urology. Prostate ablation with TULSA is an outpatient procedure, with excellent treatment success and short recovery times for patients with lower grade disease, for salvage of radiation-recurrent disease, or for any patient seeking a treatment option that has substantially lower rates of side effects and risks. I previously developed one of the first TULSA centers in the USA in conjunction with the urologists at Yale, and currently I am the only one in the Boston area performing these procedures.

Hello all,

I am very proud to announce that I have started working at Boston Medical Center (BMC) in the South End district of downtown Boston. BMC is the medical institution of Boston University, where I will be appointed as an Associate Professor of Radiology. BMC is the safety net hospital of Boston, and so I have the privilege of being part of a team that provides exceptional care to anyone and everyone Boston, without exception. You can find me [email protected], or at 617-638-6646.

Sincerely,
​Dr. Raj Ayyagari

Some articles I have recently contributed to regarding MRI-guided prostate cancer procedures.

MRI-guided prostate biopsy is done via a "trans-perineal" route, which mean the needle passes through the skin instead of through the rectum, so the infection risk is much lower. Secondly, the needle is directed to the exact target within the prostate in real time under real imaging guidance, rather than using a combination of educated guesswork and software coordination to target the area.

For treatment of prostate cancer, the MRI-guided transurethral prostate gland ablation procedure is a true game-changer. For appropriate candidates, it can deliver a cure with a small fraction of the risks, pain, and recovery time.  There is a lot more out there on MRI-guided prostate ablation (see the "Prostate Cancer Treatment" page here on my website), but this article is a good start.

Having published our data on all of the different aspects of clinical improvement that Prostate Artery Embolization (PAE) delivers, we chose next to focus our efforts on making sure PAE gets accepted into the American Urological Association's BPH treatment guidelines. These guidelines are what almost all major insurance companies use to decide what BPH treatments they will cover. Unfortunately, the AUA BPH treatment guidelines have continued to mis-categorize PAE as "experimental" even though there are now over a decade's worth of strong clinical research demonstrating its effectiveness and safety (including previous papers our group has published). These guidelines cite what is in reality a largely unfounded concern about an extraordinarily steep learning curve to master PAE, as well as another unfounded concern about the radiation dose involved in PAE.  In this paper, we were able to demonstrate the learning curve for PAE is no more of an issue than it is with other PAE surgeries that urologists perform, and that a PAE operator who is skilled and knowledgeable can obtain safe and effective results from the beginning.

Interesting case report we put together about successful non-operative management of a rare but known possible risk of a kidney biopsy.

Hello again patients and friends,

I recently decided to leave my practice at Yale, after 11 rich and rewarding years of treating hundreds of patients with the Prostate Artery Embolization (PAE) procedure, and after having built one of the few practices in the world that also performed MRI-guided prostate gland biopsies and MRI-guided prostate cancer ablation procedures. I had a wonderful time there, and really valued the collaboration with my many colleagues in Urology and other specialties at Yale and beyond. My wife is also a physician and just finished her training, and we had always wanted to move back to the Boston area to be closer to family, so we decided to make the jump!

After getting settled in my new position, I will look forward to continuing relationships with patients from my time at Yale, as well to building a new practice in the Boston area. I look forward to this new opportunity with great enthusiasm!

​Dr. Raj Ayyagari

In this paper, we dived into detail about how Prostate Artery Embolization (PAE) improves the various components of urinary symptoms caused by BPH. Again, we were privileged to have this published by the top urological sciences journal, "Urology."

Was very happy to be invited to contribute 2 manuscripts about the Prostate Artery Embolization (PAE) procedure to this special edition of the journal Techniques in Vascular and Interventional Radiology, guest edited by Dr. Shivank Bhatia.  Thank you Shivank!

I was privileged with an invitation to meet with many of the top Prostate Artery Embolization (PAE) operators in the western hemisphere to contribute to our Society of Interventional Radiology's mission to advancing research about the PAE procedure.

As promised, here is our second key Prostate Artery Embolization (PAE) manuscript. This one describes we achieved in patients with prostate-related bleeding in the urine (hematuria) and urinary retention. This time we published our data in a tip Urology journal (titled "Urology", appropriately enough). Again, great data from a great procedure! Still more to come...

Prostate Artery Embolization (PAE) is an excellent treatment option for all the problems that BPH causes. These include 1) lower urinary tract symptoms (aka "LUTS") such as weak stream, urgency, and getting up at night; 2) gross hematuria, meaning bleeding from the prostate into the urine; and 3) urinary retention, when the prostate blockage is so bad that the patient can't urinate at all, and is dependent on a urinary catheter.

At Yale, we have built one of the largest and most successful PAE practices in the country. We are now going about publishing our results! Here is the first key PAE paper we wrote, published in the Journal of Vascular and Interventional Radiology, about our experience using PAE to treat LUTS. We had great results, as good as the best results that are published out there. PAE is a great procedure! We have more publications to come about PAE for hematuria and urinary retention...

Here is a paper I published in the Journal of Vascular and Interventional Radiology regarding the use of a balloon-tipped microcatheter in Prostate Artery Embolization (PAE).

An earlier opinion piece in the realm of Prostate Artery Embolization (PAE), designed to spark conversation and debate about future possibilities in less invasive prostate cancer treatment. Prostate chemoembolization is definitely a long way off from any human clinical application, but it is an interesting idea to say the least...

Hello again,

I was sorting through some old files and dug up these manuscripts I contributed to, which are related to bladder function. These might be of some interest.

Thanks,
​Dr. Ayyagari

Hello patients and friends!
 
Many of you might have seen me in a New Haven Register article or featured in a Yale Medicine video recently. As you might know, I have been performing prostate embolization (PAE) for several years now, and I wanted to share my experience with this procedure so that patients who are likely to benefit from PAE can be treated appropriately.
 
On the day of the New Haven Register interview, I sat down with health columnist Ed Stannard. We discussed my views on the pros and cons of prostate embolization, and the important role that interventional radiologists like myself will play in the future of prostate care. Some of my former patients even shared their experiences with the procedure. Check out the article today!
 
I was also featured in an informative video created by Yale Medicine. In this video, I explain how the procedure works, and one of my patients describes how prostate embolization helped relieve his urinary retention from an enlarged prostate gland. Watch the video and learn about other patient experiences here.
 
If you or someone you know might benefit from a consultation, please contact me to make an appointment today. I look forward to meeting you.
 
Yours,
Raj Ayyagari MD

Hello patients and friends!

I was recently a featured guest on Yale's Cancer Answers podcast. Although I'm most known for my experience with prostate embolization, I also pride myself in practicing the full suite of interventional radiology. Listen to the recording below for my thoughts on minimally invasive therapies for treating cancer, and visit the Yale Cancer Answers podcast page to hear from some of my colleagues.

Call or email today to schedule an appointment to see if an interventional radiology procedure could be right for you!

Yours,
Raj Ayyagari MD

Hello patients and friends!
 
This has been an exciting week in the world of BPH because of a major announcement by the US Food and Drug Administration (FDA). On Thursday, June 22, the FDA officially approved a product, Merit Medical’s Embospheres, to be used in the prostatic artery embolization (PAE) procedure to treat enlarged prostates without invasive surgery.

Over the past several years, I have worked with leaders in the field of interventional radiology to refine my technique to improve the safety and effectiveness of prostate embolization.  As the most experienced PAE provider in the Northeastern United States, I have seen many of my own patients suffer from weak stream, incomplete emptying, frequent urination, and blood in their urine. After a consultation to determine if they are good candidates for the procedure, I have helped dozens of patients get their lives back again with this minimally-invasive procedure (watch testimonial). Based on my experience with this procedure, I feel that increased awareness of PAE and its availability as an option in the physician’s toolkit is a step forward for patients everywhere.

I look forward to the next chapter of care for men with enlarged prostates. With improved access to PAE and a greater opportunity to understand patient outcomes, we are poised to help millions of men who suffer from BPH. I started this website so that patients, family members, and other healthcare providers can learn more about enlarged prostates, prostate embolization, and the world of interventional radiology. Please “like” the Raj Ayyagari MD Facebook page to hear about new blog posts and developments in our field.  If you or someone you know suffers from an enlarged prostate and would like medical advice, please contact the number below to make an appointment.

Make an appointment with Raj Ayyagari MD today! 

Note: Although the advice on this page and others provides general medical knowledge, each patient should seek a one-on-one consultation with a physician for the best individualized care.