., et al. - This study intended to investigate the evidence for a definitive perineal urethrostomy (PU). To objectify the proportion of individuals not completing the final stage procedure in an intended multi-stage urethroplasty. To analyze the incentives for both of these scenarios. This research enrolled individuals with a definitive PU and individuals after ≥ 1 stages of an intended multi-stage urethroplasty. Patients < 18 years or with a follow-up < 3 m were eliminated. Researchers applied descriptive statistics and groups were compared with nonparametric statistical tests. Thirty-four individuals underwent a definitive PU and 63 underwent ≥ 1 stages of an intended multi-stage urethroplasty with a median (IQR) follow-up of respectively 57 (31-120) and 32 (14-101) months among 1015 urethroplasties. Definitive PU is especially conducted in older individuals with a worse cardiovascular condition, pan urethral stricture disease, and longer strictures. The results of this study showed that PU is often explicitly chosen by well-informed individuals and as nearly half of the patients refuse closure of the urethrostomy after the first stage, a definitive PU should be proposed as a reasonable alternative to complicated urethral reconstruction from the start, especially in older patients.