1 Guidance

1 Guidance

1.1 Current evidence on the efficacy of electrocauterycutting balloon treatment for pelviureteric junction(PUJ) obstruction is limited in quantity. Theevidence on safety raises concern about the risk ofbleeding. Therefore this procedure should only beused with special arrangements for clinicalgovernance, consent and audit or research.

1.2 Clinicians wishing to undertake electrocauterycutting balloon treatment for PUJ obstructionshould take the following actions.

  • Inform the clinical governance leads intheir Trusts.

  • Ensure that patients and their parents/carersunderstand that there is a risk of bleeding as aresult of the procedure, and a risk ofobstruction recurrence in the longer term, andprovide them with clear written information. Inaddition, the use of NICE's information for patients ('Understanding NICE guidance') isrecommended.

  • Audit and review clinical outcomes of allpatients having electrocautery cutting balloontreatment for PUJ obstruction (see section 3.1).

1.3 Patient selection and treatment should be carried out only in units that can offer a range of procedures including laparoscopic pyeloplasty.

  • National Institute for Health and Care Excellence (NICE)