Gynaecology

Myomectomy (Fibroid Removal)

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed November 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is a Myomectomy?

Myomectomy, sometimes referred to as fibroidectomy, is a surgery to remove fibroids from the uterus. Unlike a hysterectomy, a myomectomy just removes the fibroids but leaves the uterus intact, meaning you can still get pregnant.

There are different types of myomectomy, depending on the type and size of your fibroids. The most common types of myomectomy are abdominal myomectomy (fibroids removed through an incision in your lower abdomen), laparoscopic myomectomy (fibroids removed through several small incisions) and hysteroscopic myomectomy (where a special scope is used to remove fibroids through the vagina and cervix).

A myomectomy is carried out under a general anaesthetic and you may need several weeks to recover from the surgery, depending on which type of fibroid removal you have.

Although myomectomy is an effective method of fibroid removal, it is not suitable for all types of fibroid. Your gynaecologist will be able to recommend the best fibroids treatment according to the size, number and position of your fibroids.

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What are fibroids?

Fibroids are benign (non-cancerous) growths made up of muscle and fibrous tissue that develop in or around the uterus (womb). They vary in size from the size of a pea up to the size of a melon. Some women may not even be aware that they have fibroids, but around one in three will experience fibroids symptoms such as heavy or painful periods, abdominal or lower back pain, pain during sex,  a frequent need to urinate and constipation. In rare cases, fibroids may cause infertility and problems in pregnancy.

There are three main types of fibroids:

  • Intramural fibroids: These are the most common type of fibroid. Intramural fibroids develop in the muscle wall of the uterus.
  • Subserosal fibroids: These fibroids develop outside the uterine wall into the pelvis and can be very large in size. In some cases, these may be attached to the uterus with a narrow stalk of tissue, and are known as pedunculated fibroids.
  • Submucosal fibroids: This particular type of fibroids develop in the muscle layer beneath the inner lining of the uterus. They grow into the uterine cavity. Just like subserosal fibroids, submucosal fibroids can be attached to the uterus via a stalk.

Fibroids are linked to oestrogen production and most commonly found in women aged 30 to 50. Fibroids are less common in women who have had children and women who have been through menopause.

Fibroids are more common in African-Caribbean women and are also more likely to occur in women who are overweight or obese.

Around one in three women will develop fibroids at some point in their lives.

What are the symptoms of fibroids?

Although most women who have fibroids don’t experience any symptoms at all, around one third will experience one or more of the following symptoms. These can range in severity from mild to severe.

  • Heavy and/or painful periods
  • Pain in the abdomen
  • Bloating or swelling in the abdomen
  • Pain in the lower back
  • A feeling of ‘fullness’ in the abdomen
  • Pain during sex (if the fibroids are in the vagina or close to the cervix)
  • Constipation (if a fibroid is pushing on the bowel)
  • Frequently needing to urinate (if a fibroid is pressing on the bladder)

If you are trying to conceive, you may find that the presence of fibroids is making it difficult to get pregnant. Very rarely, fibroids can cause miscarriage. The presence of fibroids while pregnant means it is more likely that you will need a caesarean section to give birth.

If your fibroids are causing you to have heavy periods, this can lead to low iron levels or anaemia.

Fibroids do not always require treatment unless they are causing any of these symptoms.  However, they can increase in size over time and fibroids symptoms may change or get worse. Sometimes fibroids may even go away on their own.


The cost of a Myomectomy (Fibroid Removal)

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How are fibroids diagnosed?

A pelvic examination will be carried out to find out if fibroids are present. A doctor will carry out an ultrasound scan by moving a probe over the abdomen or a small ultrasound probe may be inserted into the vagina to look for signs of fibroids.

A hysteroscopy will then be carried out. This diagnostic method involves inserting a small telescope (hysteroscope) into the uterus via the vagina and cervix. This is used to look for fibroids growing inside the womb. It takes around five minutes to carry out, and a local or general anaesthetic may be used, although this is not always needed.

During a laparoscopy, a surgeon will make a small incision in your abdomen in order to examine the organs and tissues inside the abdomen and pelvis using a small telescope with a light source and camera (a laparoscope). The doctor can view these images taken by the camera on a monitor. A general anaesthetic is used for a laparoscopy. This diagnostic method is best for checking for fibroids outside the uterus or sitting in the muscle surrounding the uterus.

Sometimes a small sample of tissue may be removed during a hysteroscopy or laparoscopy for closer examination. This tissue sampling is known as a biopsy.

Who is suitable for a myomectomy?

You are suitable for fibroid removal if one or more of the following are true:

  • You have fibroids growing on your cervix, uterus, vagina or surrounding areas
  • Your fibroids are causing heavy and/or painful periods
  • Your fibroids are causing pain in the abdomen or lower back
  • You experience pain during sex due to the presence of fibroids
  • You fibroids are affecting your bowel or bladder habits
  • You regularly need treatment for low iron levels or anaemia as a result of heavy periods caused by fibroids
  • Your fibroids are making it difficult to conceive

Myomectomy Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

It is not fully understood why fibroids develop, but they have been linked to levels of oestrogen, the female reproductive hormone which is produced by the ovaries

Fibroids usually develop during a woman's reproductive years when oestrogen levels are at their highest. This is between the ages of 16 and 50, although fibroids are more common in women aged between 30 and 50. Fibroids tend to shrink when oestrogen samples are low, for example after menopause. Women who are overweight or obese have higher oestrogen levels, meaning they are at a greater risk of developing fibroids.

In rare cases, fibroids may cause significant problems, depending on their size and location.

Pregnant women with fibroids are at risk of miscarriage or premature labour. If you have a particularly large fibroid blocking the vagina, it may be necessary to deliver the baby via C-section instead of vaginally. Sometimes fibroids may also lead to problems with the baby’s development in the uterus.

Fibroids can also be responsible for infertility, preventing a fertilised egg attaching to the uterine lining or even preventing fertilisation itself.

A submucosal fibroid, which grows from the muscle wall into the cavity of the uterus, may block a fallopian tube and prevent the egg from travelling into the uterus.

There are various fibroid treatments available, including non-surgical methods, medications to shrink the fibroids and medications to relieve the symptoms of heavy, painful periods.

However surgery is the most effective way of getting rid of fibroids. A myomectomy can successfully remove fibroids from the uterine wall. It is a good alternative to a hysterectomy as it means you will be able to keep your uterus and have children if you want to.

A myomectomy is not suitable for all types of fibroid, but your doctor will be able to advise if the procedure is suitable for you.

Myomectomy can be a major surgery, depending on which surgical technique your surgeon opts for. A myomectomy is carried out under a general anaesthetic and recovery times vary from two to three days for a hysteroscopic myomectomy to four to six weeks for an abdominal myomectomy (open surgery). A laparoscopic myomectomy has a recovery time of two to four weeks. Your surgeon will discuss which surgical technique is best suited to meet your needs.

A private myomectomy in the UK costs anywhere between £5,000 and £10,000. This depends on the type of myomectomy surgery and what else is included in the treatment package.

If you choose the Cadogan Clinic for your fibroid removal in London, you will get:

  • Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
  • Your myomectomy procedure at London’s leading specialist cosmetic surgery centre of excellence
  • 24/7 on-call nurse assistance
  • A Dedicated Patient Coordinator, as a personal point of contact through your journey with Cadogan
  • A preoperative medical assessment
  • Comprehensive aftercare courtesy of our specialist team of nurses

The recovery time for a myomectomy varies depending on the type of surgical technique used.

It takes around two to three days to recover from a hysteroscopic myomectomy, two to four weeks recovery from a laparoscopic myomectomy and four to six weeks from an abdominal myomectomy.

You can expect some light vaginal spotting (bleeding) or staining for anywhere from a few days up to six weeks after your fibroid treatment.

You should avoid strenuous exercise and heavy lifting until the incisions have fully healed. You may have to wait up to six weeks before having sex after surgery and three to six weeks before trying to conceive. These vary according to the type of surgery and your doctor will be able to advise you further.

Yes, you can get a myomectomy on the NHS. However the NHS has been, and continues to be, hit hard by the Covid-19 pandemic. High levels of staff sickness have had an impact on waiting times across the board. These waiting times vary from hospital to hospital. And any new waves of Covid-19 infections may result in this wait getting even longer. Because of this, many people choose to go to a private clinic for their myomectomy. At the Cadogan Clinic, there is no waiting list, so you can have the procedure promptly.


What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.




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