Urogynecology is a subspecialty of gynecology, dealing with pelvic support disorders and urinary incontinence. Urogynecologists perform pelvic plastic and reconstructive surgery in taking care of vaginal prolapse, pelvic relaxation, and urinary incontinence. Dr. Michael Lau spent years of training with Dr. C. Paul Hodgkinson, who is regarded by many as the pioneer of urogynecology.
Dr. Lau is an expert in minimally invasive surgery and has helped in the development of several patented procedures and products in this area. Applying the minimally invasive surgery technology principles and combining these with his training and experience in plastic and cosmetic surgery, Dr. Lau is concentrating his surgical practice in pelvic plastic and vaginal cosmetic surgery under only local anesthesia in his office. This enables the patients to have a faster recovery and avoids the risks of general anesthesia. It also makes the procedures more affordable.
The two main areas of urogynecology are:
The causes of urinary incontinence (involuntary loss of urine) can be due to the lack of support of the urethrovesicle junction (bladder neck) or due to an overactive bladder. The way to differentiate the causes can be as simple as using the "cough test" but can advance to the more sophisticated testing called urodynamics.
Stress urinary incontinence (SUI) describes a condition where a woman loses urine with coughing, sneezing, or other physical exertion. SUI is caused by a drop of the support for the urethrovesicle junction (UVJ), commonly referred to as the bladder neck. The lack of support is usually due to the damage of vaginal tissue and muscular structures from childbirth.
The treatment of stress incontinence, loss of urine due to coughing, sneezing, or exercise, can be done with minimally invasive surgery. These types of surgery are done on an outpatient basis with a relatively short recovery period.
An overactive bladder can lead to involuntary urine loss, or bladder urgency or urinary frequency without loss of urine. The overactive bladder problem can be investigated and then treated with medication only, without surgery.
With childbirth, aging, and often genetic predisposition, women can lose their pelvic support as they approach the age of menopause or even years before. The lack of tissue and muscle support can cause outright vaginal prolapse, the dropping of the uterus, bladder, or rectum into the vagina or even protruding out of the vagina. With the weakening of the front wall of the vagina, the bladder drops into the vagina, causing a vaginal prolapse known as cystocele. Very often the dropping of the bladder neck support of the vagina also causes urinary incontinence.
When the back wall of the vagina is weakened, the rectum drops into the vagina, causing difficulties in bowel movements. This vaginal prolapse is known as rectocele.
Even without the gross vaginal prolapse, the relaxation of the pelvic tissue and muscles can give women a sense of vaginal laxity, causing self consciousness with sexual intercourse. Using specific plastic surgical techniques, many of those having been modified by Dr. Michael Lau to be minimally invasive, the prolapse can be corrected in an outpatient setting. The vagina can be rejuvenated and tightened, restoring one's self confidence. Also, the external genitalia, the labia majora and minora can be reconstructed by the process of labioplasty (labiaplasty) to achieve the aesthetics that one might desire.