Phimosis Presenting With Preputial Calculus: A Case Report on an Uncommon Presentation of a Common Condition

Preputial calculus is a rare clinical entity in the realm of urolithiasis. It is usually seen in elderly people with poor hygiene. Experts postulate the formation to be driven by nidus deposition, accumulation of inorganic salts, and transmigration of stones along the urogenital system. An X-ray of the pelvis can confirm the diagnosis and surgical intervention can assuage the symptoms. In this case report, we describe an elderly male who presented with a hard penile swelling with a prior history of phimosis for a decade. He underwent an X-ray of the pelvis which helped diagnose a case of preputial calculus. We performed an emergency dorsal slit for the prompt removal of the calculus with follow up debridement. In conclusion, a clinical rarity such as this needs apt diagnosis and surgical mediation to treat it. Follow-up should be considered in the elderly given the possibility of malignant transformation in the future.