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Objective: We aimed to identify clinical and radiological predictors of the need for surgical intervention in infants with antenatally detected UPJO. Material and methods: We prospectively followed infants born with antenatally diagnosed ureteropelvic junction obstruction (UPJO) presented at our outpatient clinics for evidence of obstructive injury with a standard protocol with ultrasonography and renal scintigraphy. Indications for surgery included progression of hydronephrosis on serial examinations, initial differential renal function (DFR) ⩽35% or >5% loss in sequential studies, and febrile urinary tract infection (UTI). Univariate and multivariate analyses were utilized to define the predictors for surgical intervention, while the appropriate cut-off value of the initial Anteroposterior diameter (APD) was determined using the receiver operator curve analysis. Results: Univariate analysis revealed a significant association between surgery, the initial APD, cortical thickness, Society for Fetal Urology grade, UTD risk group, initial DRF, and febrile UTI ( p-value < 0.05). No significant association between surgery and sex or side of the affected kidney ( p-value 0.91 and 0.38, respectively). On multivariate analysis, the initial APD, initial DRF, obstructed renographic curve, and febrile UTI ( p-value < 0.05) were the only independent predictors for surgical intervention. An initial APD of 23 mm can predict surgical requirement, with a specificity of 95% and sensitivity of 70%. Conclusion: For antenatally diagnosed UPJO, the APD value (at the age of 1 week), DFR value (at the age of 6–8 weeks), and febrile UTI during follow-up are significant and independent predictors of the need for surgical intervention. APD, when used with a cut-off value of 23 mm, is associated with high specificity and sensitivity for predicting surgical need.

Environmental scanning is a milestone at the start of futures studies and strategic planning process. It must be done collectively and as participatory as possible to explore, create, and test both possible and desirable futures to capture opportunities of the futures images, trying to optimize it, and at the same time to avoid or reduce the risks of future threats. Internal analysis focuses on the strengths and weaknesses of an organization, while external analysis focuses on the threats and opportunities that may suddenly happen in the future. These two types of analysis provide an inventory of all variables / factors or events / drivers, internal and external that characterizes the system. But this is not enough for long-term strategic planning, the issue is not really planning, but rather the manner in which planning is executed. So advanced analysis should be done to study the direct and indirect relations among these trends, issues, variables / factors. As the vector of key variables is extracted with relations (influence, dependency) in mind, The impact of each of these key variables on each other must be taken into account relative to the system under study; CIA (Cross-Impact-Analysis) method is used to study such impacts. Future studies and forecasting methods need to benefit from this analysis to focus on the effects of these unprecedented future events. This paper introduces such work by integrating the results of strategic planning tools with futures studies methods and this could be essential for advanced analysis.