Nanda Daniswara, Donny Eka Putra, Mohammad Ayodhia Soebadi, Johan Renaldo, Gampo Alam Irdam, Adhitama Alam Soeroto, Aga Parardya, Yonas Immanuel Hutasoit, Caesar Khairul Wallad, Boyke Soebhali, Nyoman Gede Prayudi, Gede Wirya Kusuma Duarsa, IB Putra Pramana, Luki Ertandri, Ramlan Nasution, Marta Hendry, Eko Arianto, Sufriadi Sufriadi, Muhammad Adan Yashar, Syakri Syahrir, Setya Anton Tusara Wardaya, Pandu Ishaq Nandana, Eric Sebastian Hutauruk, Noor Riza Perdana, Hajid Rahmadianto Mardihusodo, Ferdi Ardiansyah, Rulianov Rulianov, Cahyo Ariwicaksono, Wyckmell Octof Ingratoeboen, J.C. Prihadi, Ogi Bahaurini Gumilar, Ardiansyah Periadi Sitompul, Andika Afriansyah, Firman Nugroho, Parsaoran Nababan, Christiano Tansol, Edwin R. P. L. Tobing, Muhammad Asykar A. Palinrungi, Bacilius Agung Priyosantoso, Indrawarman Soerohardjo, Said Alfin Khalillulah, Ahmad Agil, Edi Wibowo, Kuncoro Adi, Paksi Satyagraha
Objective: 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. Methods: 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. Results: 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. Conclusions: 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. © The Author(s) 2026.
Urology Division, Department of Surgery, Faculty of Medicine Diponegoro University, Ministry of Health Kariadi Hospital, Semarang, Indonesia; Drajat Prawiranegara Hospital, Serang, Indonesia; Urology Department, Faculty of Medicine, Airlangga University, Airlangga University Hospital, Surabaya, Indonesia; Urology Department, Faculty of Medicine, Airlangga University, Dr. Soetomo Hospital, Surabaya, Indonesia; Urology Department, Faculty of Medicine, University of Indonesia, Ministry of Health Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Balaraja Hospital, Banten, Indonesia; Ministry of Health Fatmawati Hospital, Jakarta, Indonesia; Urology Department, Faculty of Medicine, Mulawarman University Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia; Urology Department, Faculty of Medicine, Udayana University, Ministry of Health Ngoerah Hospital, Denpasar, Indonesia; Urology Department, Faculty of Medicine, Udayana University, Udayana University Hospital, Bali, Indonesia; Urology Department, Faculty of Medicine, Andalas University, Ministry of Health M. Djamil Hospital, Padang, Indonesia; Urology Department, Faculty of Medicine, North Sumatra University, Ministry of Health Adam Malik Hospital, Medan, Indonesia; Urology Department, Faculty of Medicine, Sriwijaya University, Ministry of Health Mohammad Hoesin Hospital, Palembang, Indonesia; Urology Department, Faculty of Medicine, Sam Ratulangi University, Ministry of Health R.D. Kandou Hospital, Manado, Indonesia; Dr. Achmad Mochtar Hospital, Buktitinggi, Indonesia; Arifin Achmad Hospital, Pekanbaru, Indonesia; Urology Department, Faculty of Medicine, Hasanuddin University, Ministry of Health Wahidin Sudirohusodo Hospital, Makassar, Indonesia; Urology Division, Department of Surgery, Faculty of Medicine, Sebelas Maret University, Dr. Moewardi Hospital, Surakarta, Indonesia; Urology Division, Department of Surgery, Faculty of Medicine, Mataram University, West Nusa Tenggara Province Hospital, Mataram, Indonesia; Siloam Hospitals, Kupang, Indonesia; Dr. H. Moch Ansari Saleh Hospital, Banjarmasin, Indonesia; Urology Department, Faculty of Medicine, Jenderal Soedirman University Prof. Dr. Margono Soekarjo Hospital, Purwokerto, Indonesia; Arjawinangun Hospital, Cirebon, Indonesia; Mitra Keluarga Kemayoran Hospital, Jakarta, Indonesia; Ministry of Health Johannes Leimena Hospital, Ambon, Indonesia; Urology Division, Department of Surgery, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Atma Jaya Hospital, Jakarta, Indonesia; Dr. Soebandi Hospital, Jember, Indonesia; Raden Mattaher Hospital, Jambi, Indonesia; Ministry of Health Persahabatan Hospital, Jakarta, Indonesia; Siloam Hospitals, Labuan Bajo, Indonesia; Dr. Soedarso Hospital, Pontianak, Indonesia; Urology Division, Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam Lippo Village Hospitals, Jakarta, Indonesia; Urology Department, Faculty of Medicine, Hasanuddin University, Jaury Jusuf Putera Academic Hospital, Makassar, Indonesia; Jayapura Hospital, Jayapura, Indonesia; Urology Department, Faculty of Medicine, Gajahmada University, Ministry of Health Sardjito Hospital, Yogyakarta, Indonesia; Urology Department, Faculty of Medicine, Syah Kuala University, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia; Urology Department, Faculty of Medicine, Padjadjaran University, Ministry of Health Hasan Sadikin Hospital, Bandung, Indonesia; Urology Department, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar Hospital, Malang, Indonesia
