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Gynaecology · UK

Myomectomy - fibroid surgery that keeps your uterus.

A uterus-preserving operation for symptomatic fibroids - hysteroscopic, laparoscopic, robotic or open, chosen from an MRI map and done by a consultant gynaecologist who specialises in fibroid surgery.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private myomectomy costs in the UK.

Indicative ranges across UK private providers.

In short

£4,000–£8,000, home the same day.

Procedure Indicative range
Hysteroscopic myomectomy (day-case) £4,000–£8,000
Laparoscopic myomectomy £6,000–£12,000
Robotic-assisted myomectomy £8,000–£15,000
Open (abdominal) myomectomy £5,000–£10,000
Vaginal myomectomy (prolapsing fibroid) £3,500–£6,500
Consultation + MRI review £300–£600

Prices vary by hospital, by which subspecialist does the case, by fibroid size and number, and by whether adjuncts (contained morcellation, cell salvage) are needed.

The problem

The right approach, the right surgeon, the uterus intact.

Fibroid surgery is where a general gynaecology list can go wrong - the wrong approach for the fibroid map, or a hysterectomy offered when a myomectomy would do. We fix that before you commit.

  • Not sure surgery is needed?

    UAE, MRgFUS, GnRH agonists or Mirena might be enough. We say so before you agree to theatre.

  • Told you need a hysterectomy?

    A subspecialist opinion often changes the plan. Myomectomy keeps your uterus - and your options.

  • Planning a pregnancy?

    Approach matters - a hysteroscopic resection of a submucosal fibroid may be all you need for cavity restoration.

When it helps

When myomectomy is the right step.

The situations we see most, plus the one red flag that means an urgent MRI rather than an operating slot.

  • Heavy menstrual bleeding (HMB)

    Periods that flood, clot or leave you anaemic - often the first reason fibroids are treated surgically.

  • Bulk and pressure symptoms

    A palpable lower-abdominal mass, urinary frequency, constipation or lower back ache from large or multiple fibroids.

  • Painful periods (dysmenorrhoea)

    Severe cramping that does not settle with tranexamic acid or hormonal treatment.

  • Subfertility with a distorted cavity

    Submucosal fibroids (FIGO 0–2) that intrude on the endometrial cavity and interfere with implantation.

  • Recurrent miscarriage

    A submucosal or large intramural fibroid can raise miscarriage risk - removing it may improve live-birth rates.

  • Preserving the uterus

    You want children, or you simply want to keep your uterus - myomectomy is the fertility-sparing alternative to hysterectomy.

  • Prolapsing pedunculated fibroid

    A fibroid on a stalk delivering through the cervix - usually a straightforward vaginal myomectomy.

  • Red flag: rapid growth after menopause

    A fibroid that grows quickly, especially post-menopause, needs an urgent MRI to exclude sarcoma before any surgery.

Approach options

Five routes into the same operation - plus two non-surgical alternatives.

The FIGO type, size and number of your fibroids decide which of these fits. An MRI pelvis is what tells us.

  • Hysteroscopic myomectomy

    For submucosal FIGO 0–2 fibroids. Transcervical resection with a resectoscope - no incisions, day-case, fertility-preserving.

  • Laparoscopic myomectomy

    Three to five keyhole ports for intramural and subserosal (FIGO 3–7) fibroids up to ~10 cm, typically fewer than five in number. Barbed-suture closure.

  • Robotic-assisted myomectomy

    Da Vinci platform - enhanced suturing precision for complex intramural repairs. Longer theatre time and higher cost, but growing UK adoption.

  • Open (abdominal) myomectomy

    Pfannenstiel or midline laparotomy - for very large (>12 cm), extensive (>5) or deeply intramural fibroids, or when laparoscopy is not feasible.

  • Vaginal myomectomy

    For prolapsing pedunculated cervical fibroids. Short, day-case, no abdominal incision.

  • Uterine artery embolisation (UAE)

    IR-led alternative (NICE IPG367). Not surgery - fertility outcomes debated, so we discuss it carefully if pregnancy is a goal.

  • MRgFUS (focused ultrasound)

    Incision-free MR-guided focused ultrasound - see /treatments/high-intensity-focused-ultrasound-hifu. Suits selected fibroids and selected patients.

  • Consultation + MRI review

Safety and recovery

What to expect afterwards - honestly.

Myomectomy is a common gynaecological operation, but a bloodier one than most people expect. Approach choice, morcellation technique and pregnancy timing are the three things worth understanding.

  • Bleeding is the main risk

    Uterine muscle is highly vascular. Vasopressin infiltration reduces bleeding; 5–15% of large or multiple cases need a transfusion.

  • Conversion to open surgery

    Fewer than 5% of laparoscopic cases convert to a laparotomy - usually for bleeding or for a fibroid larger than anticipated.

  • Hysterectomy as a last resort

    A hysterectomy for uncontrollable bleeding is rare but possible - consented for in every myomectomy. About 10–15% of women eventually need one within 10 years.

  • Bowel, bladder or ureteric injury

    Less than 1%. Higher with adhesions, previous surgery, or deeply posterior fibroids near the ureters.

  • Uterine rupture in later pregnancy

    Rare (<1%). Elective caesarean at 38–39 weeks is usually recommended after cavity breach or large intramural repair - RCOG guidance.

  • Recurrence of new fibroids

    Myomectomy treats today’s fibroids - 10–30% of women grow new ones within 5 years. Not a failure of surgery, just fibroid biology.

  • Morcellation and sarcoma risk

    Very rare undiagnosed sarcomas can be disseminated by open morcellation. Pre-op MRI screening and contained (in-bag) morcellation mitigate this MHRA/FDA-flagged risk.

  • Infection, DVT and adhesions

    Prophylactic antibiotics and TED stockings are standard. Adhesion formation is more common with open surgery and can affect future fertility.

  • Red flags after surgery

    Fever, worsening abdominal pain, heavy vaginal bleeding, calf swelling or breathlessness - call the on-call team or A&E the same day.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever approach was used, the note the gynaecologist sends you keeps to the same shape.

A UK consultant gynaecologist reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your review, just ask.

  1. 01 Header

    Indication and approach chosen

    Why the myomectomy was done - HMB, pressure, fertility - and which route (hysteroscopic, laparoscopic, robotic, open) was used.

  2. 02 Technique

    Fibroid map, technique and closure

    The number, size and FIGO type of fibroids removed, the suture layers used, whether the cavity was breached, and how bleeding was controlled.

  3. 03 Findings

    Histology and intra-operative findings

    Pathology confirmation that the tissue was benign leiomyoma (not sarcoma), plus notes on adhesions, endometriosis or other pelvic findings.

  4. 04 Impression

    Recovery, pregnancy timing, mode of birth

    Read this first: when to try for pregnancy (typically 3–6 months), whether elective caesarean is recommended, and follow-up.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for myomectomy varies by insurer and by indication - usually funded when fibroids are symptomatic and medically indicated.

Frequently asked

Everything we get asked about myomectomy.

Quick answers on approach, cost, alternatives, recovery, and pregnancy after fibroid surgery.

  • What is a myomectomy?

    Surgical removal of uterine fibroids while preserving the uterus. It is the fertility-sparing alternative to hysterectomy and can be done hysteroscopically (through the cervix), laparoscopically, robotically, or through an open abdominal incision - the approach depends on the size, number and location of your fibroids.

  • Which approach is right for me?

    Submucosal fibroids (FIGO 0–2) are almost always hysteroscopic. Intramural and subserosal fibroids (FIGO 3–7) up to about 10 cm and fewer than five in number suit laparoscopic or robotic surgery. Very large (>12 cm), very numerous or deeply complex fibroids usually need an open myomectomy. An MRI pelvis is what decides it.

  • How much does a private myomectomy cost in the UK?

    Roughly £4–8k for hysteroscopic, £6–12k for laparoscopic, £8–15k for robotic, and £5–10k for open myomectomy. Insurance coverage varies - usually funded when fibroids are symptomatic and medically indicated.

  • Are there alternatives to myomectomy?

    Yes. Uterine artery embolisation (UAE, NICE IPG367), MR-guided focused ultrasound (MRgFUS), GnRH agonists like Zoladex or Prostap for temporary shrinkage, the Mirena coil for heavy bleeding when the cavity is normal, and - if your family is complete - hysterectomy. Ulipristal acetate was withdrawn in the UK in 2020 for liver toxicity.

  • Will I still be able to have children?

    Usually yes - that is the main reason to choose myomectomy over hysterectomy. Live-birth rates of 40–70% are reported for women trying to conceive after surgery, depending on age, fibroid burden and other fertility factors. Waiting 3–6 months before conceiving lets the uterus heal.

  • Will I need a caesarean if I get pregnant?

    Often, but not always. The RCOG advises elective caesarean at 38–39 weeks after an extensive myomectomy that breached the uterine cavity or involved a large intramural repair. A vaginal birth may still be safe if the scar is minor and well-healed - your obstetrician will decide case by case.

  • How long is recovery?

    Hysteroscopic - home the same day, office work in 3–5 days. Laparoscopic or robotic - one to two nights in hospital, back to desk work in 2–4 weeks, no heavy lifting for 6 weeks. Open - three to five nights, back to work in 4–6 weeks, no heavy lifting for 8–12 weeks.

  • Will my fibroids come back?

    New fibroids develop in 10–30% of women within 5 years of myomectomy. That is fibroid biology, not surgical failure. About 10–15% of women eventually go on to hysterectomy within 10 years for recurrent symptoms.

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