Calculi in the urethra are an uncommon entity. Giant calculi in prostatic urethra are extremely rare. The decision about treatment strategy of calculi depends upon the size, shape, and position of the calculus and the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most of the previous reported cases, giant calculi were extracted via the transvesical approach and external urethrotomy. A 38-year-old male patient presented with complaints of lower urinary tract symptoms. Further investigations showed a giant urethral calculus secondary to stricture of bulbo-membranous part of the urethra. Surgical removal of calculus was done via transvesical approach. Two calculi were found and extracted. One was a huge dumbbell calculus and the other was a smaller round calculus. This case was reported because of the rare size and the dumbbell nature of the stone. Giant urethral calculi are better managed by open surgery. 1. Introduction Urinary calculi are the third most common affliction of the urinary tract, exceeded only by urinary tract infections and pathologic conditions of the prostate [1]. Urethral calculi represent 1-2% of all calculi in the genito-urinary tract [2]. Primary urethral calculi are usually associated with urethral strictures, posterior urethral valve, or a diverticula [3]. Giant calculi occurring in prostatic urethra are extremely rare. Only few cases of giant prostatic urethral calculi are reported in literature. Here we present a case of giant dumbbell shaped calculus in prostatic urethra. 2. History and Clinical Examination A 38-year-old male patient, labourer by occupation came with complaints of decreased urinary stream, straining during micturition, and dysuria for six months. He had no history of haematuria, fever, vomiting, or trauma, but the patient had feeling of incomplete emptying. He was evaluated for these symptoms in a local hospital where X ray KUB and urethra were done and then he was referred to our hospital for further management. The patient had a significant past history of undergoing a suprapubic catheterisation and some endoscopic urethral procedure but without any documents. Clinical examination of abdomen revealed a scar in the suprapubic region. Calculus was palpable in the perianal region and also on per rectal examination. External genitalia was normal. 3. Investigations ？Haematology: complete blood count, renal function tests, liver function tests, serum electrolytes, serum parathyroid hormone, and serum calcium levels were within normal
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