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Urinary tract stone is a common phenomenon following severe recurrent dehydration and stasis of urine. They usually form in various shapes and sizes. The reported case was a very unique in shape and size and was formed by the interplay of various precipitating factors including loss of urinary bladder control following spinal injury. Method: Review of indexed case, the management, radiographic film as well as review of published literatures. Result: The index case was 45 year old paraplegic, who presented with urinary retention, supra-pubic and right iliac fossa pain. Past history of repeated fasting from water. He had emergency x-ray of the pelvis which showed two large super-imposed oval shaped homogenous opacities of calcific densities in the pelvic cavity measuring approximately 42x50 mm & 39 x 48 mm. He had a repeat cystolithotomy under general anesthesia. First episode was performed five years ago. The excised stones were uniquely tetrahedron prism in shape. The dry weight of one of them was 46g with range of 4.3 to 4.5 cm in dimensions, while the other was 42 g with 4.2 to 4.3 centimeters in dimensions. The combine weight of calcium containing stones narrowly escape the criteria of a massive stone, but their shape remains unique. Conclusion: The stress of surgery and anesthesia can be averted when preventive measures toward stone formation are been practiced.

Large double Tetrahedral and Prismic bladder stones: A unique Vesicolithotomy findings in a paraplegic: