Encrusted cystitis is a rare chronic inflammatory condition of the bladder. The case of a male patient with dysuria and gross hematuria accompanied by the passage of stone fragments is presented. Multimodal therapy was undertaken. He was treated with Renacidin (citric acid mixture) irrigation as an inpatient. One month later, he underwent cystourethroscopy and was determined to have residual stone and fibrosis of the prostatic urethra. The patient was then treated with cystolitholapaxy and visual internal urethrotomy. This multimodal treatment resulted in resolution of his stone burden at follow-up.