Joshua E., 5

Five-year-old Joshua is a cheerful, bright boy, the first child and only son of his family. A Nursery Two pupil at Amazing Grace Academy, Iburu, Kaduna, he loves cartoons and playing with his friends. His father is a farmer, and his mother balances her studies with caring for the family. Since birth, Joshua has struggled to pass urine, straining painfully, passing only small amounts, and leaking urine around his scrotal area. His worried parents took him to the hospital, where doctors diagnosed perineal hypospadias, a congenital condition in which the urinary opening forms in the wrong position, disrupting the normal flow of urine. Sadly, an earlier surgery elsewhere (suprapubic catheterization and a poorly done urethral repair, later reversed) failed and even worsened his symptoms. Joshua now needs specialist corrective surgery to finally give him a normal, pain-free way to pass urine.

The prognosis is improved with timely intervention, as hydronephrosis (accumulation of fluid in the kidney) could reduce renal function and damage the kidneys, and the child is also at risk of recurrent urinary tract infections. Left untreated, Joshua faces a lifetime of painful, obstructed urination, with constant straining and poor urine flow putting him at risk of recurrent infections, bladder damage, and eventual kidney injury. The abnormal opening and leakage also carry deep social and psychological consequences as he grows, from shame and isolation to future problems with fertility and sexual function. Specialist corrective surgery now can restore normal urination and give him a completely normal life.