Current evidence on the efficacy of electrocautery cutting balloon treatment for pelviureteric junction (PUJ) obstruction is limited in quantity. The evidence on safety raises concern about the risk of bleeding. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake electrocautery cutting balloon treatment for PUJ obstruction should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients and their parents or carers understand that there is a risk of bleeding as a result of the procedure, and a risk of obstruction recurrence in the longer term, and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having electrocautery cutting balloon treatment for PUJ obstruction (see section 3.1).
Patient selection and treatment should be carried out only in units that can offer a range of procedures including laparoscopic pyeloplasty.