Rashan Williams, a deli manager, frequently had to lift heavy boxes. However, one day, while bending to pick up a box, she felt something unusual. It didn’t hurt, but she sensed something wasn’t quite right, especially after a visit to the restroom.
“I would wipe and feel a bulge, almost like something was protruding [from my vagina],” said the 42-year-old from St. Petersburg, Florida.
As time went by, this bulge seemed to drop lower and lower.
“I could manage it,” she explained. “I can push it out, or shift it to the side. It was just bizarre.”
Eventually, Williams discovered that she was dealing with a pelvic organ prolapse—a condition where weak pelvic floor muscles cause internal organs like the bladder, uterus, or bowels to sag into the vaginal canal.
Statistics reveal that up to 50% of women may experience some type of prolapse in their lives, with factors such as childbirth, body weight, and aging heightening the risk. Surprisingly, only 18-50% of them pursue medical help, and about 30% are unaware that surgery could resolve the issue.
For Williams, it took her a decade to uncover what was going on with her body.
Struggles with the Bulge
Apart from the bulge, Williams also dealt with heavy menstrual cycles and frequent urges to use the restroom, leading to many breaks at her job.
Despite her discomfort, multiple obstetricians failed to identify any problem.
“Every time I went in, it felt like I just got dismissed because they couldn’t find anything. It was disheartening,” she recalled. “After so many visits, I began to lose hope.”
The prolapse didn’t hinder her ability to walk, nor did it cause her pain. But that persistent feeling was still there.
“I kept visiting doctors, and nobody noticed anything,” Williams lamented. “If I can feel it, how can they not see it?”
Dr. Nyarai Chinyani Mushonga, a urogynecologist at Orlando Health Bayfront Hospital, observed that Williams’ extended journey to diagnosis isn’t typical.
“I know something’s down there. I’m not imagining this. I can feel something bulging out of me,” said Williams.
Dr. Mushonga noted, “Typically, it shouldn’t take that long to spot it—after all, it’s clearly visible. It’s like when a baby’s head is crowning during delivery.”
However, symptoms such as incontinence and pressure in the stomach can mislead doctors into thinking the issue lies in the digestive system or urinary tract, plus pelvic prolapse might not always be easy to detect.
Interestingly, whether a patient visits a doctor in the morning or later in the day can affect visibility—the prolapse might not show as much after a night of lying down.
Dr. Mushonga recounted an instance of not being able to spot a prolapse until the patient duplicated a specific physical therapy exercise that made it visible.
Seeking Answers
Despite being dismissed, Williams persevered in her quest for answers.
“I know something’s not right. I can feel it,” she insisted.
When she finally consulted Dr. Mushonga, relief was on the horizon. As the only double board certified urogynecologist in St. Petersburg, she emphasized how crucial it is to have access to the right specialists.
“After just one visit with her, it was as if all my questions had been answered,” Williams expressed. “Ten long years of confusion, and now I finally had options.”
She was even open to undergoing a hysterectomy if that was necessary.
“I really didn’t care about having my period anymore,” she said enthusiastically. “I was like, where do I sign? This is the best deal.”
Surgical Solutions
Dr. Mushonga treated Williams’ prolapse by removing the uterus, which was descending into the vaginal canal and pressing against the bladder. With two sutures, she repositioned everything correctly.
In some cases, surgical options might involve a “Y mesh” that functions like suspenders to hold up the vagina, rectum, and bladder.
While surgeons can preserve the uterus during surgery, Dr. Mushonga noted that it typically comes with a higher risk of complications.
“Often I suggest to patients that if they’re undergoing this surgery, it’s best to ensure the highest chance of success,” she pointed out.
If there’s a history of abnormal pap smears, she recommends a total or supracervical hysterectomy to minimize cervical cancer risks.
Each surgical experience for pelvic prolapse varies, based on factors like a patient’s age and activity level.
Williams noted her recovery was remarkably smooth. “I was up and about in just a week without any issues,” she shared.
No more frequent bathroom trips— and goodbye to that unwelcome bulge.
