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Boston, MA: 617-414-4969

Portland, ME (Fore River Urology): 207-518-6600

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Raj.Ayyagari@BMC.org

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PAE Patient Portal

Treatments
Our Patients
For Physicians
About Us
Contact Dr. Ayyagari
PAE Patient Portal

Contact Dr. Ayyagari

Contact Us

Treatment Options Discussion

Please provide your (or your patient’s) information, and I will be happy to discuss treatment options with you. Please fill out the International Prostate Symptom Score sheet (“IPSS) in the form.

Here’s a downloadable PDF version of the IPSS Form, if needed.

URL

This field is for validation purposes and should be left unchanged.

Patient Information

First Name(Required)

Last Name(Required)

Email(Required)

Phone Number(Required)

Date of Birth(Required)

Location Preference(Required)

Do you have visible blood in your urine?(Required)

Yes

No

Do you use a catheter to drain your urine?(Required)

Yes

No

Any recently diagnosed urinary infections?(Required)

Yes

No

What BPH medicines are you on?(Required)

Tamsulosin

Alfuzosin

Finasteride

Dutasteride

Tadalafil

Sildenafil

Other

Other BPH Medicines you are on:(Required)

Who is your urologist?

International Prostate Symptom Score ("IPSS")

In the past month:

1. Incomplete Emptying: How often have had the sensation of not emptying your bladder?(Required)

2. Frequency: How often have you had to urinate less than every 2 hours?(Required)

3. Intermittency: How often have you found you stopped and started again several times when you urinated?(Required)

4. Urgency: How often have you found it difficult to postpone urination?(Required)

5. Weak Stream: How often have you had a weak urinary stream?(Required)

6. Straining: How often have you had to strain to start urination?(Required)

7. Nocturia: How many times do you typically get up at night to urinate?(Required)

Quality of Life: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?(Required)

Additional Comments

HIPAA Notice(Required)

I agree.

I UNDERSTAND THAT IF I SUBMIT THE INFORMATION BELOW, I AM DOING SO VOLUNTARILY AND THAT IT CONTAINS PERSONALLY IDENTIFIABLE INFORMATION.

New England Locations

Where to See Dr. Ayyagari

Dr. Ayyagari sees patients across New England, with separate scheduling at each location.

Boston, MA

Boston Medical Center

Department of Interventional Radiology

725 Albany Street, Suite 3B
Boston, MA 02118
617-414-4969
Fax: 617-414-1698

Schedule in Boston

Portland, ME

New

Fore River Urology

Outpatient PAE & Varicocele Embolization

21 Donald B Dean Dr
South Portland, ME 04106
207-518-6600
Fax: 207-541-7445

Schedule in Portland

Board-certified Interventional Radiologist specializing in minimally invasive prostate treatments and men’s health. Serving patients across New England.

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Treatments

Prostate Artery Embolization
Varicocele Embolization
Other Treatments

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Locations

Boston, MA

Boston Medical Center
725 Albany St, Suite 3B
Boston, MA 02118
617-414-4969

Portland, ME NEW

Fore River Urology
21 Donald B Dean Dr
South Portland, ME 04106
207-518-6600