Urinary bladder calculus accounts for < 5% of urinary calculi. Elderly men are more prone to bladder calculus secondary to intravesical obstruction caused by benign prostatic hyperplasia, neurogenic bladder and urinary tract infection. Bladder stones are also seen in patients with augmentation cystoplasty and neobladder construction following radical cystectomy due to chronic exposure to intestinal mucosa. However, primary bladder calculus in the absence of renal stones is rare and presentation

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... as renal failure is rarely reported. We present a case of young male without prior significant past medical history presenting with acute renal failure and was found to have massive urinary bladder calculus, discussing the etiopathology and management.