This is a case report of a 45 year old mentally retarded patient presented with a large urethral calculus(5.5cm×4cm×4cm) impacted in bulbar urethra complicated with periurethral abscess and retention of urine. The periurethral abscess was drained and urinary diversion was done by suprapubic cystostomy. The stone was extracted later on by open urethrotomy. Introduction Urethral calculi represent less than 2% of all urinary stones. It usually develops in the presence of divertricula or infection1. This is a case of a mentally retarded patient presenting with severe perineal sepsis due to a giant calculus impacted in the bulbar urethral fossa. Case report A 45 year old patient was presented in emergency at afternoon with complaints of swelling over scrotum extending up to penis and inability to pass urine since last night. The patient was mentally retarded since childhood. The patient was dehydrated and having high grade fever. The patient’s relatives did not give history of previous trauma or retention. On examination fluctuant swelling was present in perineum with surrounding induration. Plane X ray pelvis shows a large calculus in bulbar urethra.
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