INTRODUCTION: Posterior urethral valve (PUV) and vesical calculus are individually among the most common causes of obstructive lower urinary symptoms in children. Intermittent urinary retention can be caused by a combination of PUVs and bladder stones. There are very few reports of an association between PUVs and bladder calculus. CASE PRESENTATION: We present a case of intermittent urinary retention resulting from a stone obstructing the PUV. The patient experienced intermittent urinary retention for over a month. A computed tomography scan revealed a bladder stone in the posterior urethra. The intracorporeal lithotripsy for calculus with fulguration of the PUV was performed using holmium:YAG laser. CONCLUSION: For any boy presenting with urinary retention, we recommend a thorough urethral assessment
the absence of significant abnormalities in the urethra on voiding cystourethrography cannot rule out the presence of relevant PUV
hence, bladder endoscopy may sometimes be required for further evaluation, to rule out vesical calculus and potential PUVs.