The standard treatment for hydrocephalus is either a ventriculoperitoneal or a ventriculo-atrial shunt. However, these conventional shunts may be associated with considerable complications and high revision rates which make these familiar shunts inappropriate for a certain subset of patients. A rare complication is reported associated with an unusual procedure in a 42-year-old woman who had had a ventriculovesical shunt for four years. She presented with recurrent urinary tract infections, haematuria and urge incontinence, and was discovered to have a large vesical stone over the vesical end of the shunt. She was treated with open suprapubic cystolithotomy and the redirection of the shunt to the peritoneal cavity. The patient was followed up for 12 months postoperatively and remained free of any urinary tract symptoms.