Working as a deli manager, Rashan Williams needs to lift some heavy boxes. It was while bending over to do that when she would notice something “shift.”
It wasn’t painful. But she knew something was wrong, especially when she went to the bathroom.
“I would wipe. I would feel a bulge, like something was hanging out [of my vagina],” the 42-year-old from St. Petersburg, Florida, said.
Years passed, and the bulge dropped lower and lower.
“I could maneuver it,” she said. “I can push it out. I can flip it to the side. It was just crazy.”
Williams would later learn she was suffering from a pelvic organ prolapse, a condition in which the pelvic floor muscles and tissue weaken, causing surrounding organs — like the bladder, uterus or bowels — to sag into the vaginal canal.
Up to 50% of all women will experience some prolapse in their lifetime, with childbirth, heavier body weight and aging all increasing risk. Yet only 18-50% of them seek medical attention. And 30% of women aren’t aware surgery can fix the problem.
Williams was one of the women who tried to get answers — and it took 10 years to learn what was happening to her.
Battle with the bulge
Besides the bulge, Williams also experienced heavy periods and was constantly needing to pee, requiring frequent breaks at work.
Yet she saw multiple obstetricians who didn’t see anything wrong.
“I kept getting the door shut in my face, because everybody was telling me they didn’t see anything. Nothing was wrong,” she said. “After going to so many doctors over the years, that caused me to get discouraged and I just kind of stopped.”
The prolapse never affected her ability to walk and she was never in pain. But that “block” was still there.
“I kept going to doctors and they weren’t seeing nothing wrong,” Williams said. “I’m like, if I feel it, how can y’all not see it?”
Rashan’s long journey to diagnosis is not typical, Dr. Nyarai Chinyani Mushonga, a urogynecologist at Orlando Health Bayfront Hospital, told The Post.
“I know something’s down there. Like, I’m not tripping. I’m feeling something bulging out of my body.”
Rashan Williams
“It typically just doesn’t take that long for someone to find it. It’s literally a bulge coming out of your vagina,” Mushonga said. She adds that people who’ve given birth describe it like a baby’s head crowning.
That said, symptoms like incontinence and stomach pressure can lead doctors to think the problem is with the digestive system or urinary tract. Plus, pelvic prolapse can sometimes be hard to spot.
It even makes a difference if a patient comes in the morning versus later in the day — after lying down all night, the prolapse might be less visible, Mushonga said. Getting pulled by gravity all day can make it more visible later in the day.
Mushonga remembers that she couldn’t spot the prolapse in one patient until they replicated a specific exercise the patient had done in physical therapy, which pushed the prolapse down and made it visible.
Getting answers
Williams didn’t let the dismissals stop her from seeking answers.
“I know something’s down there. Like, I’m not tripping,” she said. “I’m feeling something bulging out of my body.”
When she met Mushonga, she finally got relief. Mushonga is the only double board certified urogynecologist in Saint Petersburg. Sometimes lack of access to the right doctor can play a role in delayed diagnosis, she explained.
“After my first visit with her, all my questions were answered,” Williams said. “And just over at least ten years of not understanding, I have pure relief that there was an option to fix the situation.”
Williams already knew she’d be open to a hysterectomy, or removal of the uterus.
“I couldn’t care less to have a menstrual,” she said. “I was like, sign me up right now — I’m getting the best deal.”
Surgical solutions
Mushonga was able to treat the prolapse by removing William’s uterus, which was falling down into the vaginal canal and pressing on the bladder. She then put everything else back in its rightful place with two sutures holding up the vagina.
In other patients, doctors might use a “Y mesh” that works like a pair of suspenders — but instead of pulling up pants, it holds up the vagina, rectum and bladder.
While it’s possible for prolapse surgery to preserve the uterus, Mushonga said it carries an increased risk of failure.
“A lot of times I’m like, ‘You’re going through all this trouble to have this expensive surgery. I would give myself the best shot and the most successful route,’” she said.
If a patient has a history of abnormal pap smears, it might be a good idea to also remove the cervix — called a “total” or “supracervical” hysterectomy — to reduce the risk of cervical cancer.
Every pelvic prolapse surgery is individual, Mushonga said. Age and level of activity are also factors.
Rashan’s recovery was “easy, all the way, across the board,” she said. “I was up and walking around like a week later with no problems.”
No more constant bathroom breaks — and no more unwelcome bulge.
