We present a 60-year-old man who presented with gross hematuria, refractory lower urinary tract symptoms, and increasing bladder pain for a duration of 3 months. The patient had a history of a motorcycle accident and pelvic fracture requiring an extensive pelvic open reduction and internal fixation. During evaluation, the patient was found to have an orthopedic screw from his hardware eroding through the left lateral wall of his bladder and irritating his trigone. The patient underwent pelvic exploration with open cystotomy and hardware removal with the orthopedic service. His postoperative course was uneventful, and the patient's symptoms completely resolved.