What is Fibroids?

Fibroids/myomas are common benign (not cancerous) tumors that grow in the wall or muscle of the uterus (womb). Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a watermelon. Occasionally they may grow to a size bigger than a 9-month baby. A fibroid may remain very small for a long time and suddenly grow rapidly, or grow slowly over a number of years.

Location of Fibroids in the Uterus?

Fibroids can grow in different parts and different depths of the uterus.

  • Submucosal: These grow in the cavity of the uterus
  • Intramural: These grow in the muscle or body of the uterus
  • Sub serous: These grow outside or on the outer surface of the uterus.
  • Cervical: These grow in the neck of the uterus


There are many symptoms caused by fibroids. All these affect a woman’s general and reproductive health and have a serious impact on her personal and professional life.

  • Heavy bleeding. Sometimes this is so severe that it can cause severe chronic anaemia. This results in feeling tired, lack of energy, feeling sleepy and generally unable to enjoy life or easily undertake normal day to day activities.
  • Painful periods
  • Increased frequency of passing urine
  • Passing only small amounts of urine
  • Sometimes unable to pass urine despite a full bladder. This is a severely painful condition and is an emergency. It can cause serious long-term problems with your urinary bladder where you may need long-term catheterisation.
  • Lower backache
  • Constipation
  • Rectal pain
  • Difficulty in opening bowels
  • Enlarged abdomen
  • Pain during sex
  • Inability to get pregnant.
  • If you are able to get pregnant, you are at risk of the following:
    • Increased risk of miscarriage
    • Severe pain with pregnancy
    • Increased risk of preterm labour and delivery
    • Increased risk of wrong position of baby
    • Increased risk of placental abruption
    • Increased risk of caesarean section
    • Increased risk of bleeding before delivery, during delivery or immediately after delivery
Effect on Your life

Women with fibroids may experience one or a combination of the above symptoms. This clearly shows that fibroids can affect all aspects of a woman’s life. You could either be suffering from very heavy periods with flooding and resulting anemia or have severe pain making you incapable of leading a normal life.

It may affect your bowel function or bladder function. It may affect your fertility and if you do become pregnant, then you still have many other risks listed above, such as, miscarriage, preterm labour, placental abruption, caesarean section and severe bleeding.

Your overall body image and self-confidence is affected if the fibroids are large enough to give you a distended tummy, giving the appearance of a pregnancy.

Research has proven that women show significant emotional response to their fibroids including fear, anxiety, anger and depression. Women also feel helpless and believe that they have no control over their fibroids. For many women this leads to a negative self-image, they have concerns over appearing less attractive which leads to difficulties becoming intimate.


Uterine fibroids/myomas are benign tumors. They are most commonly diagnosed in women in their 30s and 40s but can be present from the time of start of menstruation. By the age of 50, 70% of women may have myomas of different sizes.

Training, Skill and Experience of Dr Salma Kayani

Traditionally, 99% of Gynaecologists in the world remove fibroids by making a large 10-12 inch horizontal or vertical cut on the tummy.

Dr (Mrs) Salma Kayani is among the few 1% expert Consultant Gynaecologists in the world who are able to remove large fibroids through keyhole surgery. This means that she is able to remove very large fibroids through a 5 mm cut in the tummy.

This type of keyhole surgery requires extensive skill and experience. Dr Salma Kayani has undergone 5 years of extensive training at the top teaching hospitals of England to excel in this type of surgery.

As an expert advance minimal access surgeon, the operation is undertaken safely and efficiently. After the keyhole operation, the patient has very little pain, very little blood loss, minimal scars and is ready to go home the very same day or the next day. Women resume their normal activities within 2-3 weeks after surgery. After laparoscopic removal of the fibroids, all the symptoms that the woman had been suffering from are 100% treated.

"Dr Salma Kayani is also able to undertake this surgery by keyhole technique in virgins or women who are not sexually active, ensuring a safe surgery with no damage to the hymen and virtually no scars."

Laparoscopic and Hysteroscopic Treatment of Fibroids
  • The main and definitive treatment of fibroids is to remove them surgically. This surgical procedure is known as Myomectomy.
    Depending on the location of the fibroids, Dr Salma Kayani is trained formally to remove fibroids via:
    • Laparoscopic Myomectomy: Removal of fibroids, via "Abdominal key-hole surgery"
    • Trans Cervical Resection of Fibroids (TCRF) (Hysteroscopically)- removal of fibroids, via "the neck of the womb without any cuts to the abdomen or anywhere else".

Multiple fibroids- Laparoscopic Myomectomy


All fibroids have been removed through key hole surgrey


Large uterine fibroid


Large Uterine Fibroid removed very neatly and precisely with keyhole surgery


Uterus repaired with precision by keyhole surgery


(These still images are from the live surgeries of Dr (Mrs) Salma Kayani)

You may be given some temporary medical treatments prior to your operation (Injections, Tablets) to prepare you for the surgery. It is important to remember that these treatments are temporary and are only given to calm down the fibroids and are not permanent cure of the fibroids.

"After the keyhole surgery (removal of your fibroids) Your chances of becoming pregnant are increased three folds".

Dr (Mrs) Salma Kayani’s International Research and Publications on Fibroids

Pundir J, Pundir V, Walavalkar R, Omanwa K, Lancaster G, Salma I Kayani. Robotic-Assisted Laparoscopic vs Abdominal and Laparoscopic Myomectomy: Systematic Review and Meta-Analysis. J Minim Invasive Gynecol. 2013 May-Jun;20(3):335-45. doi: 10.1016/j.jmig.2012.12.010.Epub 2013 Feb 27.

Bruno Deval, Pascal Rousset, Salma Kayani. Case Report:Vaginal Myomectomy for a Thirteen-Centimeter Anterior Myoma. Case Reports in Obstetrics and Gynaecology, Volume 2013, Article ID 285243, 3 pages

Frequently Asked Questions

What age can you get fibroids?

Women of all ages can have fibroids. The most common age group of women diagnosed with fibroids is from 30s to 40s. Fibroids can develop from the time of start of periods that is, from the ages of 12-13 onwards till very old age.

What causes fibroids?

No one knows the clear answer but research has shown that there are more than one factors which cause fibroids. These include:

  • Hormones: Estrogens and Progestogens
  • Genetics factors
  • Environmental factors
  • Dietary factors or
  • All of the above

Do fibroids run in families?

Yes fibroids do run in families. Having a close family member (mother, grandmother, aunt, sister) with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about three times higher than average.

Are some ethnicities more prone to fibroids?

Yes. Below is the order of ethnic frequency.

  • African women
  • Middle East and North Africa (MENA) region women
  • South East Asian women
  • European/Caucasian women

Can diet affect fibroids?

Eating a lot of red meat (e.g., beef) is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

Can I do something to avoid having/to prevent fibroids?

If you are genetically predisposed then there is very little you can do. However, eating healthily and maintaining your weight will reduce your risk of developing fibroids. Women who are overweight are at a higher risk of fibroids. For very obese women, the risk is 2-3 times greater than average.

Can fibroids turns into cancer?

Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.

Can I become pregnant after removal of fibroids with keyhole surgery?

Yes, your chances of becoming pregnant are significantly increased after keyhole surgery for fibroids. If you have fibroids removed by open surgery, then the chances of getting pregnant are reduced.

What if I become pregnant and have fibroids?

Fibroids grow rapidly during pregnancy and women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn't mean there will definitely be problems. The most common problems seen in women with fibroids are:

  • Caesarean section: The risk of caesarean section is 6 times higher for women with fibroids
  • Baby can be breech/oblique/transverse: the baby is not positioned well for vaginal delivery
  • Labour fails to progress
  • Placental abruption: The placenta separates away from the wall of the uterus before delivery. When this happens the baby does not get enough oxygen and will need emergency caesarean section
  • Preterm Delivery: Your baby may deliver much before its due date as there is no room for it to grow due to the fibroid occupying the space.

Talk to your obstetrician if you have fibroids and have become pregnant. You will need special antenatal care.

How do I know for sure that I have Fibroids?

Your Gynaecologist may find fibroids during:

  • Routine examination
  • By Ultrasound

You may find that you have fibroids incidentally during the following investigations:

  • Hysterosalpingogram (HSG): done to check why you have not been able to get pregnant
  • X Rays of the abdomen, back and pelvis (for any other reason)

Your Gynaecologist may want to do the following investigations to confirm the presence of fibroids:

  • MRI
  • CT scan