A60-year-old man presented with a complaint of a hard mass in the subnavicular fossa for the past 10 years. He had had minimal discomfort in micturition for the past 2 years but was able to manage with it. He had a history of passing a calculus of 1 cm diameter 15 years ago. On examination, a hard mass of 7×5×4 cm was palpable in the subnavicular fossa (Figure 1). Rectal examination was normal. Urine culture and sensitivity showed no growth, the renal parameters, metabolic work-up, plain X-ray and ultrasound scans of the kidney, ureter and bladder area were all normal. X-ray of the penis showed a large calculus in the subnavicular fossa Meatotomy was done and a calculus of 6×4×3.5 cm was extracted (Figure 2), which weighed 40 g. The meatus was reconstructed with Blandy's flap. The postoperative period was uneventful.
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