Abstract
Prostate calculi, or prostatic stones, are typically small, greyish-brown, ultrasound-dense formations composed mainly of carbonated calcium phosphate apatite. We present a 65-year-old male with severe lower urinary tract symptoms (LUTS), including weak urinary stream, difficulty urinating, and acute retention, who was found to have a 4 cm prostate stone. Imaging confirmed obstruction of the prostatic urethra. Surgical intervention with transurethral resection of the prostate (TURP) and Holmium laser lithotripsy successfully removed the stone and relieved symptoms. This case emphasizes the need to consider prostate stones in severe LUTS when conventional treatments fail, with regular follow-up to monitor recurrence.