Abstract
Preputial calculi are the rarest form of urolithiasis seen usually in an uncircumcised male with phimosis. We report a case in an elderly male who presented with azotaemia. Calculi are evident on clinical examination by palpation. Late presentation by the patient leads to complications. Treatment is by dorsal slit or circumcision. The case highlights the need of early recognition and treatment of this rare condition to prevent any complication.