Tongue Tie
What is tongue-tie?
Tongue-tie, or ankyloglossia, is a congenital condition in which the lingual frenulum (the band of tissue that anchors the bottom of the tongue to the floor of the mouth) is abnormally short and thick, which prevents the tongue from moving freely. While some babies seem unbothered by it, in others it can cause them to struggle when breastfeeding, which is often when the condition is noticed. Tongue-tie is thought to affect 4-11% of newborn babies and is more common in boys than girls.
Symptoms of tongue-tie
The key symptom is the short, thick membrane holding the tongue to the bottom of the mouth, which can make the tongue form a heart shape when they stick it out. This, in turn, can cause several signs that might alert the baby’s parents or doctors to the problem:
Being hungry all the time
A clicking sound when the baby feeds.
Difficulty moving or sticking out the tongue.
Difficulty latching on to the nipple or staying attached when breastfeeding.
Being underweight or not gaining weight as quickly as expected.
If the baby has tongue-tie, this can also affect the mother’s breasts. For example, she may suffer from sore or cracked nipples or mastitis (inflammation of the breast), and her milk supply may be lower than it should be.
In older children and adults, tongue-tie can impede speech and could cause difficulty eating certain food.
What causes undescended testis?
The cause of undescended testis is not completely known. For some reason there is a mistake in the process which is moving the testis from the tummy, where the testis is developed, to the scrotum. This migration should occur in the last two months of foetal life but it can also happen in the first three months of postnatal life as mentioned above.
It is thought that there may be several factors - such as genetics, environmental factors, and maternal health - which could disrupt hormones and nerve activity, impacting on the development and migration of the testicles.
Risk factors associated with an undescended testicle in newborn boys include: premature birth; a low birth weight; foetal conditions which can restrict growth, like a defect in the abdominal wall or Down Syndrome; use of cigarette smoking or alcohol during pregnancy.
How to recognise an undescended testis?
The main presentation of an undescended testis is an empty scrotum with a non-palpable testicle. This condition is usually identified shortly after birth. Under routine newborn examinations, if the testis has not descended into the scrotum by the age of three months, it is unlikely to do so on its own and surgical intervention (orchidopexy) becomes necessary.
Mr. C.K. Sinha specialises in the diagnosis and surgical treatment of undescended testis. Early surgical correction is essential—not only to improve future fertility potential but also to allow easier monitoring for testicular abnormalities, such as lumps or testicular cancer. Additionally, correction ensures a normal appearance of the scrotum, which can be important for psychological well-being.
Mr. Sinha provides expert and compassionate care for children with this condition, ensuring both parents and children are well-supported throughout the treatment journey.
Treatment options for undescended testis
The surgery to correct undescended testis is called orchidopexy. It requires one small incision in the groin and a second one in the scrotum. This operation is usually performed as a day case, and your child will be back to his normal in a couple of days.
Key-hole surgery (laparoscopy), which uses a tiny camera placed through the belly button, is needed when the testicle in non-palpable in the groin. It is possible, in this case, that the testicle is either inside the abdomen or it was never developed.
Surgery involves the careful manipulation of the testicle to separate some congenital adhesions that are keeping the testis away from the scrotum. Then a tunnel and a pouch are created to bring the testis in the final position inside the scrotum where the testis is stitched in place.
For cases in which the testicle is abnormal, or not developed, the recommendation is to remove the nibble or small residual testis to avoid problems, such as cancer, in the adult life.
An inguinal hernia or hydrocele may be associated with the undescended testis, and they can be repaired during the same operation.
Following the procedure, the testicle will be monitored for a few years to ensure that it is developing normally, and it remains in place.
"Mr C.K. Sinha took excellent care of our son, who underwent surgery for his testicle. From the very first consultation through to the surgery and aftercare, he was exceptional—highly professional, calm, and genuinely caring. He made us feel completely at ease and confident throughout the process. We truly felt our son was in the best possible hands. We would wholeheartedly recommend him."
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MR CK SHINA
Consultant Paediatric Urologist & Paediatric Surgeon