Indonesian update of urethral stricture characteristics and treatment patterns

To evaluate the clinical profile and treatment patterns of urethral stricture (US) in Indonesia, the world’s fourth most populous country. Since 2012, Indonesia has expanded access to reconstructive urology services, supported by 19 genitourinary consultants and multiple referral centers nationwide. A multicenter retrospective study was conducted involving urologists from 38 hospitals across Indonesia. Data from patients treated for US between 2019 and 2023 were collected, including demographics, stricture characteristics (site and etiology), and treatment modalities. Stricture length was recorded but excluded from the primary analysis due to inconsistent reporting across participating centers. Surgical procedures were categorized as direct vision internal urethrotomy (DVIU), urethral dilatation, excision and primary anastomosis (EPA), and substitution urethroplasty. A total of 3,055 patients were included, with a mean age of 49.3 years (SD 18.8; range 1–91); 99.3% were male. The leading causes of US were iatrogenic (38.4%), trauma (38.0%), and infection (17.7%), followed by idiopathic (5.4%), and congenital (0.5%). The bulbar urethra was the most commonly affected anatomical site (24.3%), followed by membranous (13.9%), pendular (7.6%), and panurethral strictures (11.6%). Surgical reconstruction was the primary approach in 65.7% of cases, including Excision and Primary Anastomosis (EPA) in 33.1% and urethroplasty in 32.6%. Augmentation urethroplasty using oral mucosal grafts was performed in 16.6%. Endoscopic management—primarily Direct Vision Internal Urethrotomy (DVIU) and dilatation—was employed in 30.5% of patients. Reconstructive surgery, particularly urethroplasty, is now the dominant modality for US management in Indonesia. The predominance of trauma-related urethral strictures reflects epidemiological patterns commonly observed in developing and middle-income countries. However, a national registry and expanded training in reconstructive urology are crucial to further enhance outcomes and standardize care delivery across Indonesia.

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Journal
BMC Urology
Published
2026-02-24
DOI
https://doi.org/10.1186/s12894-026-02082-9
Primary Topic
Urological Disorders and Treatments
Type
article
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article

Indonesian update of urethral stricture characteristics and treatment patterns

Ahmad Agil, Nyoman Gede Prayudi, Setya Anton Tusara Wardaya, Aga Parardya et al.
BMC Urology
Urological Disorders and Treatments
article

Indonesian update of urethral stricture characteristics and treatment patterns

Ahmad Agil, Nyoman Gede Prayudi, Setya Anton Tusara Wardaya, Aga Parardya, Nanda Daniswara, Adhitama Alam Soeroto, Kuncoro Adi, Syakri Syahrir, Yonas Immanuel Hutasoit, Noor Riza Perdana, Bacilius Agung Priyosantoso, Gampo Alam Irdam, Eric Sebastian Hutauruk, Ogi Bahaurini Gumilar, Muhammad Adan Yashar, Luki Ertandri, Marta Hendry, Ramlan Nasution, Gede Wirya Kusuma Duarsa, Ardiansyah Periadi Sitompul, Andika Afriansyah, St Cahyo Ariwicaksono, Caesar Khairul Wallad, Rulianov Rulianov, Indrawarman Soerohardjo, Parsaoran Nababan, Edi Wibowo, InaGURS, Said Alfin Khalillulah, Muhammad Asykar A. Palinrungi, Edwin R. P. L. Tobing, Johan Renaldo, IB Putra Pramana, Christiano Tansol, Hajid Rahmadianto Mardihusodo, Sufriadi Sufriadi, Mohammad Ayodhia Soebadi, JC Prihadi, Firman Nugroho, Pandu Ishaq Nandana, Ferdi Ardiansyah, Wyckmell Octof Ingratoeboen, Eko Arianto, Donny Eka Putra
article en

Abstract

To evaluate the clinical profile and treatment patterns of urethral stricture (US) in Indonesia, the world’s fourth most populous country. Since 2012, Indonesia has expanded access to reconstructive urology services, supported by 19 genitourinary consultants and multiple referral centers nationwide. A multicenter retrospective study was conducted involving urologists from 38 hospitals across Indonesia. Data from patients treated for US between 2019 and 2023 were collected, including demographics, stricture characteristics (site and etiology), and treatment modalities. Stricture length was recorded but excluded from the primary analysis due to inconsistent reporting across participating centers. Surgical procedures were categorized as direct vision internal urethrotomy (DVIU), urethral dilatation, excision and primary anastomosis (EPA), and substitution urethroplasty. A total of 3,055 patients were included, with a mean age of 49.3 years (SD 18.8; range 1–91); 99.3% were male. The leading causes of US were iatrogenic (38.4%), trauma (38.0%), and infection (17.7%), followed by idiopathic (5.4%), and congenital (0.5%). The bulbar urethra was the most commonly affected anatomical site (24.3%), followed by membranous (13.9%), pendular (7.6%), and panurethral strictures (11.6%). Surgical reconstruction was the primary approach in 65.7% of cases, including Excision and Primary Anastomosis (EPA) in 33.1% and urethroplasty in 32.6%. Augmentation urethroplasty using oral mucosal grafts was performed in 16.6%. Endoscopic management—primarily Direct Vision Internal Urethrotomy (DVIU) and dilatation—was employed in 30.5% of patients. Reconstructive surgery, particularly urethroplasty, is now the dominant modality for US management in Indonesia. The predominance of trauma-related urethral strictures reflects epidemiological patterns commonly observed in developing and middle-income countries. However, a national registry and expanded training in reconstructive urology are crucial to further enhance outcomes and standardize care delivery across Indonesia.

BMC Urology
Pelita Harapan University (ID), Sebelas Maret University (ID), Udayana University (ID), Atma Jaya Catholic University of Indonesia (ID), University of Mataram (ID), University of Brawijaya (ID), Sugarcane Research Center (Brazil) (BR), Universitas Syiah Kuala (ID), Universitas Airlangga (ID), Jenderal Soedirman University (ID), Sriwijaya University (ID), Dr. Kariadi Hospital (ID), Cenderawasih University (ID), Dr. Hasan Sadikin General Hospital (ID), Universitas Achmad Yani (ID), Ministry of Health (OM), Universitas Muhammadiyah Cirebon (ID), Kementerian Kesehatan Republik Indonesia (ID), Universitas Muhammadiyah Pontianak (ID), Siloam Eye Hospital (KR), Universitas 45 Mataram (ID), Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo (ID), Rumah Sakit Umum Pusat Dr. Sardjito (ID), Universitas Kebangsaan Republik Indonesia (ID), University Teaching Hospital of Butare (RW), Fatmawati Hospital (ID), Mulawarman University (ID), Sam Ratulangi University (ID), Andalas University (ID), Hasanuddin University (ID)
Openalex Percentile: Top 42%
Urological Disorders and Treatments
DOIOpen Access PDFOpenAlex
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