Giant prostatic calculi are very rare. We present the case of a 45-year-old man with multiple prostatic urethral calculi that replaced the entire gland. He underwent an open "prostatolithotomy," a novel method of stone removal akin to a simple retropubic prostatectomy. Eight stones weighing a total of 59 g were removed from the prostate. For certain patients, adjunctive vesical neck revision and deliberate drainage of the prostatic fossa may be beneficial in addition to stone extraction.