Indonesian update of urethral stricture characteristics and treatment patterns.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Daniswara Nanda, Putra Donny Eka, Soebadi Mohammad Ayodhia, Renaldo Johan, Irdam Gampo Alam, Soeroto Adhitama Alam, Parardya Aga, Hutasoit Yonas Immanuel, Wallad Caesar Khairul, Soebhali Boyke, Prayudi Nyoman Gede, Duarsa Gede Wirya Kusuma, Pramana I B Putra, Ertandri Luki, Nasution Ramlan, Hendry Marta, Arianto Eko, Sufriadi Sufriadi, Yashar Muhammad Adan, Syahrir Syakri, Wardaya Setya Anton Tusara, Nandana Pandu Ishaq, Hutauruk Eric Sebastian, Perdana Noor Riza, Mardihusodo Hajid Rahmadianto, Ardiansyah Ferdi, Rulianov Rulianov, Ariwicaksono Cahyo, Ingratoeboen Wyckmell Octof, Prihadi J C, Gumilar Ogi Bahaurini, Sitompul Ardiansyah Periadi, Afriansyah Andika, Nugroho Firman, Nababan Parsaoran, Tansol Christiano, Tobing Edwin R P L, Palinrungi Muhammad Asykar A, Priyosantoso Bacilius Agung, Soerohardjo Indrawarman, Khalillulah Said Alfin, Agil Ahmad, Wibowo Edi, Adi Kuncoro, Satyagraha Paksi, InaGURS
Аннотация
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.