ABSTRACT
A very unusual case of a huge calculus, extending from the urethra into a dorso-lateral urethra-cutaneous fistula is reported in an 8-year-old African boy who underwent primary bladder closure for exstrophy at the age of 16 months, followed by epispadias surgery 6 months later. The patient was lost to follow-up after exstrophy-epispadias surgery for 6 years. At 8 years of age, he presented with a fistulized distal urethra forming a diverticulum-like structure containing a round stone with a diameter of 28 mm. The fistula was opened, the stone removed and urethroplasty was performed. Such urethral calculus has, to our knowledge, not been previously reported in exstrophy-epispadias [EE] surgery. This case shows the necessity and importance of careful long-term follow-up, as such a severe complication may develop well after primary surgery