Fibroid on the outside (subserous), inside(submucous) and within the muscle (intra mural) of the womb


Fibroids are extremely common affecting around 40% of ladies over forty in the UK. They are benign tumours (very rarely malignant) composed of smooth muscle and fibrous tissue and in the main cause no symptoms at all. If symptoms do occur they are either heavy periods, pressure effects on the bladder or bowel or sometimes pain. You may also feel a lump arising from the pelvis if the fibroids are relatively large.

Fibroids are classified according to where they are in relation to the womb (see picture). Those sticking into the cavity are called submucous and these tend to cause period problems such as heavy periods or bleeding between periods. If they need treating they can usually be removed hysteroscopically (from down below) as a relatively minor procedure.

sub serous fibroid

Fibroids buried within the muscle of the womb are called intramural fibroids. These can cause heavy bleeding or pressure symptoms and if they need removal this is called a myomectomy. This is an operation through the abdomen and can be done either as an open operation or laparoscopically (keyhole). In cases where a lady has finished her family it is often preferable, both from the easy of surgery and to reduce the risk of recurrence, to have a hysterectomy. Depending on the size of the womb this may be done laparoscopically (keyhole) or, if the womb is too large, as an open operation.

Fibroids protruding from the outside of the womb are called subserous fibroids. These tend to cause pressure symptoms rather than bleeding problems and if they need removing this can be done laparoscopically (keyhole) or as an open procedure.

sub mucous fibroid

In most cases an additional option to surgery for symptomatic fibroids is uterine artery embolisation / fibroid embolisation. This is a procedure carried out by interventional radiologists and information on this procedure can be found on Dr Walker’s website, who has carried out a very large number of these procedures.