# Dr. Art Rastinehad — Site Index for LLMs > Interventional urology practice in New York City. Dual fellowship-trained > (Urologic Oncology + Interventional Radiology, NIH). System Director of > Prostate Cancer and Vice Chairman of Lenox Hill Urology, Northwell Health. ## Doctor - Name: Art Rastinehad, D.O. (full: Ardeshir Rustom Rastinehad) - Specialty: Interventional Urology - Affiliation: Northwell Health (Lenox Hill) - Office: 130 E 77th Street, 5th Floor Black Hall, New York, NY 10075 - Phone: (212) 434-6580 - Booking: https://www.northwell.edu/find-care/find-a-doctor/urology/dr-ardeshir-rustom-rastinehad-do-11355045 ## Primary pages - / Home — overview of practice, conditions, treatments - /about Biography, credentials, fellowships, philosophy - /press Press kit: short/long bio, headshot, downloadable CV, media topics - /research Peer-reviewed publications, textbook, awards, grants - /glossary Plain-language glossary of prostate, urology, and imaging terms - /contact Office contact, hours, location, contact form - /news Press coverage and media appearances ## Conditions - /conditions/prostate-cancer Diagnosis and treatment of prostate cancer - /conditions/enlarged-prostate-bph BPH causes, symptoms, and treatment - /conditions/active-surveillance Structured monitoring of low-risk prostate cancer - /conditions/varicocele Scrotal varicocele — pain, atrophy, infertility - /conditions/renal-mass-angiomyolipoma Benign and select malignant kidney tumors - /conditions/kidney-stones Image-guided stone removal and prevention ## Condition summaries ### Prostate Cancer — /conditions/prostate-cancer Prostate cancer is the most common non-skin cancer in American men, and modern imaging and targeted biopsy have transformed how it is diagnosed, staged, and treated. Dr. Rastinehad's pathway starts with PSA and clinical exam, adds multiparametric MRI (T2, diffusion, dynamic contrast) to identify and PI-RADS-score suspicious zones, and uses MRI-fusion targeted biopsy to confirm cancer location and grade — improving detection of clinically significant disease while reducing overdiagnosis of indolent cancers. Many low- and intermediate-risk cancers are now candidates for focal therapy or active surveillance instead of whole-gland surgery or radiation. Treatment plans balance cancer control with preservation of urinary continence and erectile function, and every plan is individualized after reviewing imaging, pathology, PSA kinetics, and genomic risk. ### Benign Prostatic Hyperplasia (BPH) — /conditions/enlarged-prostate-bph BPH is the non-cancerous enlargement of the prostate that causes bothersome urinary symptoms — weak stream, urgency, frequency, nocturia, incomplete emptying — in most men over 60. Untreated BPH can progress to urinary retention, bladder stones, and kidney damage. Workup includes an IPSS symptom score, PSA, urinalysis, post-void residual, uroflowmetry, prostate volume on ultrasound or MRI, and cystoscopy when anatomy or stones are a concern. Modern treatment ranges from medication (alpha-blockers, 5-alpha reductase inhibitors) to minimally invasive options including prostate artery embolization (PAE), Rezum, UroLift, and TURP. PAE is especially valuable for very large prostates (>80 g), poor surgical candidates, and men prioritizing preservation of ejaculation and erectile function — it treats BPH without cutting prostate tissue. ### Active Surveillance — /conditions/active-surveillance Active surveillance is a structured monitoring program for low-risk prostate cancer that defers treatment until biology shows it is needed. Most men with Grade Group 1 (Gleason 6) prostate cancer — and select men with favorable intermediate-risk Grade Group 2 disease — are candidates, especially when MRI and PSA density support a low-risk profile. The program uses serial PSA every 6 months, baseline and serial multiparametric MRI, and targeted re-biopsy at 1–3 year intervals to detect grade reclassification early. Roughly one in three men eventually transition to definitive treatment, almost always for grade reclassification rather than missed aggressive disease; focal therapy, surgery, and radiation remain just as effective when started at the time of documented progression. The goal is to avoid the side effects of treatment in men whose disease was never going to harm them. ### Kidney Stones — /conditions/kidney-stones Kidney stones affect roughly one in ten Americans and cause sudden flank or groin pain (renal colic), hematuria, nausea, and sometimes fever — the warning sign of infected obstruction. Diagnosis uses low-dose non-contrast CT to locate and size the stone, with ultrasound for monitoring and pregnancy-safe evaluation. Most small stones (<5–6 mm) pass with hydration, pain control, and medical expulsive therapy; larger stones, obstructing stones, and infected stones require a procedure — ureteroscopy with laser lithotripsy for most ureteral and mid-size renal stones, and percutaneous nephrolithotomy (PCNL) through a small flank tract for large or staghorn stones. A 24-hour urine collection and stone analysis identify the metabolic driver (calcium, uric acid, cystine, oxalate) so a tailored prevention plan can break the cycle of recurrence. ### Varicocele — /conditions/varicocele A varicocele is an enlargement of the pampiniform plexus of veins that drain the testicle, similar to a varicose vein, found in roughly 15% of adult men and 40% of men with primary infertility. About 85% are left-sided due to venous anatomy, 10% are bilateral, and isolated right-sided varicoceles warrant retroperitoneal imaging. Symptoms range from a dull scrotal ache that worsens with standing or exercise to testicular atrophy and abnormal semen analysis. Diagnosis uses a physical exam with Valsalva maneuver, scrotal Doppler ultrasound, and semen analysis when fertility is a concern. Treatment is recommended for pain, testicular volume loss, or male-factor infertility, and embolization through a single pinhole in the wrist or neck offers a no-incision, no-general-anesthesia alternative to microsurgical varicocelectomy — with equivalent fertility outcomes, lower hydrocele rates, and 1–2 day recovery. ### Renal Mass / Angiomyolipoma — /conditions/renal-mass-angiomyolipoma Most renal masses are found incidentally on a CT or MRI ordered for another reason, and many are benign. Cross-sectional imaging (multiphase CT or MRI with and without contrast) can usually distinguish a benign angiomyolipoma (AML) — identified by characteristic fat content — from a suspicious solid mass; biopsy is reserved for indeterminate cases. AMLs greater than 4 cm or those that have bled are candidates for selective renal artery embolization, which preserves more kidney function than partial nephrectomy and reliably reduces bleeding risk. Patients with multiple or bilateral AMLs are evaluated for tuberous sclerosis. Select small malignant renal masses (renal cell carcinoma) can be managed with image-guided cryoablation or surveillance rather than surgery, particularly in older patients or those with limited renal reserve. ## Treatments - /treatments/focal-therapy Targeted ablation of prostate tumors - /treatments/prostate-artery-embolization Non-surgical BPH treatment (PAE) - /treatments/varicocele-embolization No-incision varicocele treatment - /treatments/renal-embolization Pinhole treatment for renal masses / AMLs - /treatments/cryotherapy Image-guided freezing of tumors - /treatments/clinical-trials Active interventional urology trials ## Treatment summaries ### Focal Therapy — /treatments/focal-therapy Focal therapy is the targeted destruction of a prostate tumor using energy (cryoablation, HIFU, or laser ablation) under MRI/ultrasound fusion guidance, treating only the cancerous region while sparing the rest of the gland, the urethra, and the neurovascular bundles. It sits between active surveillance and whole-gland treatment and is best suited to men with localized, MRI-visible, intermediate-risk prostate cancer who prioritize preservation of urinary and sexual function. Performed outpatient under general or spinal anesthesia in 1–2 hours; most men return to work within a week. Benefits include markedly lower rates of incontinence and erectile dysfunction versus surgery or radiation, and preservation of all future treatment options. Success is tracked with serial PSA, follow-up MRI at 6–12 months, and a confirmatory targeted biopsy. ### Prostate Artery Embolization (PAE) — /treatments/prostate-artery-embolization PAE is an outpatient, non-surgical treatment for benign prostatic hyperplasia (BPH) in which microscopic particles are delivered through a pinhole catheter in the wrist or groin to selectively block the arteries feeding the enlarged prostate, causing the gland to shrink over 4–12 weeks without removing any tissue. It is performed under local anesthesia with light sedation in 2–3 hours and most patients return to normal activity within 3–5 days, typically without a urinary catheter. PAE is especially valuable for men with very large prostates (>80 g), poor surgical candidates, and men who want to preserve ejaculation and erectile function — risks of retrograde ejaculation, incontinence, and impotence are very low because no prostate tissue is cut and the surrounding nerves are undisturbed. FDA-approved and covered by Medicare and most commercial insurers. ### Varicocele Embolization — /treatments/varicocele-embolization Varicocele embolization is a minimally invasive, image-guided treatment for symptomatic varicoceles and varicocele-related male infertility, performed with no surgical incision. A microcatheter is advanced through a small vein in the neck or groin into the internal spermatic vein under fluoroscopic guidance, and the abnormal veins are sealed with coils or a sclerosing agent so blood reroutes through healthy veins. Done under local anesthesia with light sedation in 45–90 minutes; most men return to work within 1–2 days and to strenuous exercise after about a week. Success rates are comparable to open or laparoscopic ligation, with mild access-site bruising and brief flank discomfort as the most common side effects. Many men with varicocele-related infertility see improvements in semen parameters within months. ### Renal Embolization — /treatments/renal-embolization Renal embolization is an image-guided, pinhole procedure that selectively blocks the artery feeding a kidney lesion — most often a growing angiomyolipoma (AML) — using particles or coils delivered through a microcatheter, shrinking the mass and reducing the risk of life-threatening bleeding while preserving surrounding healthy kidney tissue. It is also used for nephron-preserving management of select renal masses and for pre-operative devascularization before partial nephrectomy. Performed outpatient or as a short stay under local anesthesia with sedation in 1–2 hours; most patients return to normal activity within a week. Post-embolization syndrome (low-grade fever and flank pain for a few days) is common and self-limited; non-target embolization is rare. Most lesions show meaningful shrinkage by 3–6 months on follow-up imaging. ### Cryotherapy — /treatments/cryotherapy Cryotherapy uses thin, image-guided probes to deliver two cycles of extreme freezing and thawing to a tumor, destroying targeted cancer tissue while sparing surrounding structures. It can be used as a whole-gland or focal treatment for localized prostate cancer, as a salvage option for prostate cancer that has recurred after radiation, and for select small renal masses. Performed outpatient under general or spinal anesthesia in 1–2 hours; most patients return to normal activity within 1–2 weeks and the procedure can be repeated if needed. Benefits include a minimally invasive approach with no surgical incision and the ability to precisely target tissue; risks include temporary urinary symptoms or hematuria, possible erectile dysfunction depending on tumor location, and rare urethral or rectal injury. Cryotherapy is one of the most established salvage options for radiation-recurrent prostate cancer. ### Clinical Trials — /treatments/clinical-trials Eligible patients may enroll in active clinical trials of next-generation interventional urology techniques — including novel imaging, biopsy methods, and tumor-directed therapies — that are not yet broadly available, delivered under rigorous protocol oversight. Candidacy is determined by reviewing imaging, pathology, and history against each study's inclusion and exclusion criteria; informed consent details risks, benefits, time commitment, and what is involved before any treatment. Setting, anesthesia, duration, and recovery vary by protocol. Most study-related procedures are covered by the trial sponsor while routine clinical care is billed to insurance as usual. Participation offers early access to investigational therapies, close monitoring, and a contribution to the evidence that informs future patients. ## Detection - /detection Modern diagnostic pathway: PSA, MRI, biopsy - /detection/mri-fusion-biopsy MRI/ultrasound fusion-guided prostate biopsy ### MRI-Fusion Biopsy — /detection/mri-fusion-biopsy MRI-fusion biopsy overlays a pre-procedure multiparametric prostate MRI on real-time transrectal ultrasound so the urologist can guide a biopsy needle directly into MRI-visible lesions, dramatically improving detection of clinically significant prostate cancer compared with traditional systematic biopsy. Dr. Rastinehad led foundational multi-institutional work establishing fusion biopsy as a standard of care and helped pioneer electromagnetically tracked transperineal fusion biopsy in the United States. ## Notable firsts - First U.S. urologist dual fellowship-trained in Urologic Oncology + Interventional Radiology - First MR/US fusion-guided, electromagnetically tracked transperineal prostate biopsy - First-in-world gold-nanoshell directed photothermal ablation of prostate cancer - Senior editor: Interventional Urology (Springer, 2016) — first textbook on the subspecialty - AUA Young Urologist of the Year, 2019 ## Selected publications Curated first/senior-author papers indexed on PubMed. Full author list: https://pubmed.ncbi.nlm.nih.gov/?term=Rastinehad+AR%5BAuthor%5D - [Glue (n-Butyl Cyanoacrylate) for Prostate Artery Embolization: Development of a Glue Penetration Score and Association with Clinical Outcomes (J Vasc Interv Radiol, 2026)](https://pubmed.ncbi.nlm.nih.gov/41197868/) - [Novel MRI-US fusion with advanced annotation in focal cryoablation for prostate cancer: medium-term outcomes and learning curve insights (BJU Int, 2026)](https://pubmed.ncbi.nlm.nih.gov/41065554/) - [A Multi-Institutional Study of Magnetic Resonance/Ultrasound Fusion-Guided Nanoparticle-Directed Focal Therapy for Prostate Ablation (J Urol, 2024)](https://pubmed.ncbi.nlm.nih.gov/39226591/) - [A Detailed Clinical Case of Localized Prostate Tumors Treated with Nanoparticle-Assisted Sub-Ablative Laser Ablation (Nanomaterials (Basel), 2024)](https://pubmed.ncbi.nlm.nih.gov/39120366/) - [Narrative review-focal therapy: are we ready to change the prostate cancer treatment paradigm? (Ann Transl Med, 2023)](https://pubmed.ncbi.nlm.nih.gov/36760247/) - [Alternatives to whole gland treatment for localized prostate cancer: a review of novel focal therapies (Curr Opin Urol, 2022)](https://pubmed.ncbi.nlm.nih.gov/35552305/) - [TRUS Biopsy vs Transperineal Biopsy for Suspicion of Prostate Cancer (Urology, 2022)](https://pubmed.ncbi.nlm.nih.gov/35181407/) - [Adjunctive Coil Embolization of the Prostatic Arteries After Particle Embolization for Prostatic Artery Embolization (Cardiovasc Intervent Radiol, 2021)](https://pubmed.ncbi.nlm.nih.gov/34561744/) - [MRI Fusion Transperineal Prostate Biopsy Instructions and Troubleshooting (J Endourol, 2021)](https://pubmed.ncbi.nlm.nih.gov/34499560/) - [Novel Automated Three-Dimensional Surgical Planning Tool and Magnetic Resonance Imaging/Ultrasound Fusion Technology to Perform Nanoparticle Ablation and Cryoablation of the Prostate for Focal Therapy (J Endourol, 2022)](https://pubmed.ncbi.nlm.nih.gov/34409850/) - [Transperineal Versus Transrectal Targeted Biopsy With Use of Electromagnetically-tracked MR/US Fusion Guidance Platform for the Detection of Clinically Significant Prostate Cancer (Urology, 2020)](https://pubmed.ncbi.nlm.nih.gov/32956688/) - [Estimated Costs Associated With Radiation Therapy for Positive Surgical Margins During Radical Prostatectomy (JAMA Netw Open, 2020)](https://pubmed.ncbi.nlm.nih.gov/32232450/) - [A cohort of transperineal electromagnetically tracked magnetic resonance imaging/ultrasonography fusion-guided biopsy: assessing the impact of inter-reader variability on cancer detection (BJU Int, 2020)](https://pubmed.ncbi.nlm.nih.gov/31762182/) - [Gold nanoshell-localized photothermal ablation of prostate tumors in a clinical pilot device study (Proc Natl Acad Sci U S A, 2019)](https://pubmed.ncbi.nlm.nih.gov/31451630/) - [Advances in prostate cancer imaging (F1000Res, 2018)](https://pubmed.ncbi.nlm.nih.gov/30467517/) - [Targeted Ablative Therapies for Prostate Cancer (Cancer Treat Res, 2018)](https://pubmed.ncbi.nlm.nih.gov/30168116/) - [Implementation of multiparametric magnetic resonance imaging technology for evaluation of patients with suspicion for prostate cancer in the clinical practice setting (BJU Int, 2019)](https://pubmed.ncbi.nlm.nih.gov/30113138/) - [Risk stratification of prostate cancer utilizing apparent diffusion coefficient value and lesion volume on multiparametric MRI (J Magn Reson Imaging, 2017)](https://pubmed.ncbi.nlm.nih.gov/27405584/) - [Reproducibility of Multiparametric Magnetic Resonance Imaging and Fusion Guided Prostate Biopsy: Multi-Institutional External Validation by a Propensity Score Matched Cohort (J Urol, 2016)](https://pubmed.ncbi.nlm.nih.gov/26812301/) - [Comparison of Multiparametric MRI Scoring Systems and the Impact on Cancer Detection in Patients Undergoing MR US Fusion Guided Prostate Biopsies (PLoS One, 2015)](https://pubmed.ncbi.nlm.nih.gov/26605548/) - [In patients with a previous negative prostate biopsy and a suspicious lesion on magnetic resonance imaging, is a 12-core biopsy still necessary in addition to a targeted biopsy? (BJU Int, 2015)](https://pubmed.ncbi.nlm.nih.gov/25252133/) - [Multiparametric magnetic resonance imaging outperforms the Prostate Cancer Prevention Trial risk calculator in predicting clinically significant prostate cancer (Cancer, 2014)](https://pubmed.ncbi.nlm.nih.gov/24917122/) - [Improving detection of clinically significant prostate cancer: magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy (J Urol, 2014)](https://pubmed.ncbi.nlm.nih.gov/24333515/) - [Selective arterial prostatic embolization (SAPE) for refractory hematuria of prostatic origin (Urology, 2008)](https://pubmed.ncbi.nlm.nih.gov/18308078/) ## Glossary — /glossary Plain-language definitions of urology, prostate, kidney, imaging, and interventional treatment terms. Each term is anchor-linked at /glossary#. - Ablation — Targeted destruction of tissue using heat, cold, or laser energy. - Active surveillance — Structured monitoring of low-risk prostate cancer instead of immediate treatment. - Adverse event — Any unwanted medical occurrence during a clinical trial or treatment. - Angiomyolipoma (AML) — A benign kidney tumor made of blood vessels, smooth muscle, and fat. - Benign prostatic hyperplasia (BPH) — Non-cancerous enlargement of the prostate causing urinary symptoms. - Biomarker — A measurable biological signal used to detect or stage disease. - Bladder outlet obstruction — Blockage of urine flow at the bladder neck, usually from BPH. - Catheter — A thin flexible tube used to drain urine or deliver treatment. - Clinical trial — A research study that tests a new treatment, device, or diagnostic in humans. - Clinically significant prostate cancer — Prostate cancer aggressive enough to need treatment, not just monitoring. - Cryotherapy — Image-guided freezing used to destroy targeted tissue. - Cystoscopy — A camera exam of the urethra and bladder. - Digital rectal exam (DRE) — A clinical exam of the prostate through the rectum. - Dominant index lesion — The largest, most aggressive-appearing tumor focus in the prostate. - Embolization — Image-guided blocking of an artery using particles or coils. - Erectile dysfunction (ED) — Difficulty achieving or maintaining an erection. - Focal therapy — Treating only the prostate tumor rather than the whole gland. - Gleason score — A 6–10 score of prostate cancer aggressiveness on biopsy. - Gold-nanoshell ablation — Photothermal destruction of prostate tumors using laser-activated gold nanoparticles. - Hematuria — Blood in the urine. - HIFU (high-intensity focused ultrasound) — Focused sound waves used to thermally ablate prostate tumors. - Image-guided therapy — Treatment delivered using live imaging instead of open surgery. - Informed consent — A documented conversation explaining a procedure's risks, benefits, and alternatives. - Interventional urology — Image-guided, minimally invasive treatment of urologic disease. - IPSS (International Prostate Symptom Score) — A validated questionnaire that quantifies BPH urinary symptoms. - IRB (Institutional Review Board) — A committee that reviews and oversees clinical research to protect participants. - ISUP grade group — A 1–5 simplification of the Gleason score. - Kidney stone — A hard mineral deposit that forms in the kidney and can block urine flow. - Laser ablation — Use of focused laser light to heat and destroy targeted tissue. - Localized prostate cancer — Prostate cancer that has not spread outside the gland. - MRI-fusion biopsy — A targeted prostate biopsy that fuses prior MRI with real-time ultrasound. - Multiparametric MRI (mpMRI) — A prostate MRI protocol that combines anatomical and functional sequences. - NCT number — A unique ID assigned to a registered clinical trial on ClinicalTrials.gov. - Neurovascular bundles — Nerve and blood-vessel pairs running alongside the prostate that drive erectile function. - Nocturia — Waking up at night to urinate. - Percutaneous nephrolithotomy (PCNL) — Image-guided removal of large kidney stones through a pinhole in the back. - PI-RADS — A standardized 1-to-5 scale for scoring suspicious prostate lesions on MRI. - Prostate artery embolization (PAE) — Minimally invasive embolization treatment for BPH. - PSA (prostate-specific antigen) — A blood test used to screen for and monitor prostate disease. - PSA density — PSA value divided by prostate volume on imaging. - PSA velocity — How quickly PSA is rising over time. - PSMA PET — A nuclear scan that detects prostate cancer using a PSMA-targeted tracer. - Radical prostatectomy — Surgical removal of the entire prostate. - Renal colic — Severe wave-like pain caused by a kidney stone blocking urine flow. - Renal embolization — Image-guided occlusion of arteries feeding a kidney tumor. - Renal mass — Any solid or complex cystic lesion in the kidney. - Retrograde ejaculation — Semen entering the bladder instead of exiting during orgasm. - Salvage focal therapy — Focal ablation used to treat prostate cancer that recurs after radiation. - Sphincter (urinary) — The muscle that holds urine in the bladder. - Transperineal biopsy — A prostate biopsy approached through the perineum rather than the rectum. - Transrectal ultrasound (TRUS) — Ultrasound of the prostate performed via a rectal probe. - TURP — Surgical removal of obstructing prostate tissue through the urethra. - Ureteroscopy — Endoscopic stone removal through the urethra and ureter. - Urinary retention — Inability to fully empty the bladder. - Uroflowmetry — A test that measures urine flow rate over time. - Varicocele — Enlargement of the veins draining the testicle. - Varicocele embolization — No-incision treatment that closes the abnormal veins draining the testicle.