Abstract
Bladder calculi occur predominantly in men, and their incidence is very low in females. Female urethral calculi are even rarer and are usually associated with anatomical or pathological abnormalities. This case report describes a female patient with a giant calculus extending from the urinary bladder into the urethra, crossing the bladder neck. The patient had a three-year history of lower urinary tract symptoms before diagnosis. She was presented with acute pyelonephritis on the left side, bilateral hydronephrosis due to reflux, and recurrent urinary tract infections. An emergency cystostomy was performed at our medical center for urinary drainage, followed by open cystolithotomy. Urethroscopy revealed a urethral diverticulum near the bladder neck; however, the patient declined diverticulum resection. A five-year follow-up was conducted. This case report provides valuable insights into diagnosing and treating rare lower urinary tract calculi in females, accompanied by a literature review.