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 Raj.Ayyagari@BMC.org, or at 617-638-6646.
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...
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.
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.
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!
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.
Hello! This is my blog, where I'll be sharing stories about myself and reviewing topics that patients might be interested in learning more about. Be sure to check in and comment occasionally with what you'd like to see.
I am a board-certified Interventional Radiologist, which means I perform image-guided minimally invasive surgical procedures. These procedures are done by passing a specialized needle or catheter into a quarter-inch hole in the skin, and from there I use radiographic, ultrasound, or CT-scan guidance to steer my instruments through blood vessels or soft tissues into the organ that I wish to treat. Almost every procedure can be done with IV sedation medication alone, so the patient does not need general anesthesia. Most patients usually can return home the same day with only a small bandage on, and they can often can go back to their normal activities after only a day or two of recovery at home.
I graduated with a B.A. degree in Behavioral Biology from Swarthmore College in 1996. After completing two-and-a-half years of Peace Corps service in the Andes mountains and Amazon rain forests of Ecuador, I went to Yale School of Medicine, where I graduated with an M.D. degree in 2004. I completed the first two years of Urology residency at the University of Washington, followed by residency in Diagnostic Radiology and fellowship in Vascular and Interventional Radiology at Brigham and Women's Hospital/ Harvard Medical School in Boston, MA. After finishing my training in 2011, I came back to Yale, where I have been on faculty as an Assistant Professor and a staff interventional radiologist at Yale New Haven Hospital ever since.
I perform procedures in every part of the body, but I specialize in some remarkable minimally invasive procedures that are available to treat problems that patients have in their urinary, and reproductive organ systems, problems that can severely impact quality of life or even life expectancy. These procedures can treat such problems successfully and safely, while allowing patients to avoid more invasive surgery.
Prostatic artery embolization (PAE) is a remarkable procedure that has been around now for about 6 years. It is a safe and highly effective yet minimally invasive outpatient procedure that shrinks the prostate dramatically. This helps older men with benign prostatic hyperplasia (BPH) regain the ability to urinate normally again, without having to go through invasive surgeries like a TURP (Trans-Urethral Resection of Prostate) or prostatectomy. This is truly a revolutionary procedure that has helped many men regain control of their lives, after suffering from what can become a severe medical condition that controls one's life.
For both younger and older male patients with large dilated veins in their scrotum, and common problem known as a varicocele, I also perform a safe and highly effective and minimally invasive outpatient procedure that closes these veins and shrinks them down. This procedure is a way to treat the pain, cosmetic problems, or even concerns for fertility (ability to have children) that can plague patients with this condition.
I encourage you to contact me further if you or someone you know has one of these issues that you think I could help with.
Dr. Raj Ayyagari is a board-certified interventional radiologist based in Boston, Massachusetts, who specializes in minimally invasive procedures of the genitourinary system.