A rare delayed presentation of giant vesical calculus: the largest vesical calculus to be reported in a female

Vesical calculi are infrequent in females, and the occurrence of giant vesical calculus is even rarer. We report a case of giant vesical calculus in an elderly female which was undiagnosed and empirically treated for six years for recurrent urinary tract infection. On presentation, it was managed by open cystolithotomy. Upon surgical retrieval, the stone measured 11x7.5x7.4 cm in largest dimensions and weighed 672 gm, which to the best of our knowledge, is the largest vesical calculus to be reported in a female patient. This case highlights the need for adequate evaluation of every case of recurrent urinary tract infection with good imaging. Early diagnosis allows for the management of vesical calculi by minimally invasive endoscopic techniques. If missed, it leads to the formation of giant vesical calculi, which require treatment by a much more invasive open surgical approach.