Dr. Dimple Doshi (MBBS, MD, DGO)
Lady Gynecologist & Laparoscopic Surgeon
27+ years’ experience
20,000+ surgeries completed
Most women who reach this page are carrying both a symptom and a fear: the flooding periods are real, and so is the dread that “surgery” means losing the uterus. Does this sound like you?
Are you struggling with heavy menstrual bleeding, severe pelvic pain or bloating that shapes your month?
Has anaemia left you tired, breathless or pale — living on iron tablets?
Have you been diagnosed with fibroids and quietly fear losing your uterus?
Have you had miscarriages or difficulty conceiving with a fibroid on your reports?
Is a growing belly or pressure on the bladder changing how you dress and travel?
Have you postponed treatment because you picture a big cut and weeks in bed?
These concerns are common. Fibroids develop in 50–70% of women by menopause (StatPearls, NCBI 2025), and they arrive in exactly the decades when careers, families and fertility plans are at stake. Ignoring them can mean worsening anaemia and bulk symptoms — yet fear of hysterectomy keeps many women from ever asking what else is possible.
The good news is that uterus-preserving removal is standard practice at this clinic by both routes: Dr. Doshi has 500+ patients treated with laparoscopic myomectomy, and 50+ treated with the no-incision hysteroscopic route for cavity fibroids. The uterus stays; the fibroids go.
Myomectomy is surgery that removes uterine fibroids while preserving the uterus — the fibroid comes out, the womb stays, and fertility plans stay intact. It is done by two minimally invasive routes at this clinic: hysteroscopic myomectomy through the cervix (no cuts at all) for fibroids inside the cavity, and 3D laparoscopic myomectomy through keyhole incisions for fibroids in or on the uterine wall. The fibroid’s position — not preference — decides the route.
Uterus-preserving by definition — the alternative for completed families with severe disease is hysterectomy; myomectomy exists so that removal of fibroids never has to mean removal of the uterus.
Two routes, one decision framework — cavity fibroids via the natural passage; wall and outer fibroids via keyholes. The table below sorts them.
Also called fibroid removal surgery, keyhole myomectomy, laparoscopic fibroid removal, hysteroscopic fibroid resection.
Performed in Goregaon West, Mumbai by Dr. Dimple Doshi at Vardaan Hospital; fibroids themselves are explained on the uterine fibroids page.
The fibroid’s position on the FIGO map decides your myomectomy route. Fibroids inside the cavity (FIGO types 0–2, “submucous”) are removed hysteroscopically through the cervix. Fibroids in the wall (intramural) or on the outer surface (subserous) need the laparoscopic route. Many women have both kinds — and get a combined plan, sometimes in one anaesthetic.
Hysteroscopic myomectomy | 3D laparoscopic myomectomy | |
Fibroid position | Inside the cavity — submucous, FIGO 0/1/2 | In the wall or outside — intramural, subserous |
Typical size | Ideal under ~3 cm; larger/type-2 may need two sittings | Up to ~[clinic to confirm: 8–12 cm range]; number and access matter as much as size |
Access | Through the vagina and cervix — no cuts, no scars | 3–4 small keyhole incisions near the navel |
Anaesthesia & stay | General; day-care | General; day-care to 24-hour stay |
Uterine wall | Not cut | Incised and stitched in layers — matters for future delivery planning |
Back to routine | 1–2 days | Light activity ~1 week; work 7–10 days; full healing 4–6 weeks |
Typical trigger symptom | Flooding periods from a small cavity fibroid | Bulk, pressure, pain, or large/multiple fibroids |
Not sure which yours is? The scan report’s words — “submucous/intracavitary” vs “intramural/subserous” — answer it; a 3D ultrasound or diagnostic hysteroscopy settles borderline cases.
Sometimes it isn’t a fibroid — uterine polyps mimic small cavity fibroids (and are even easier to remove); adenomyosis mimics a bulky fibroid uterus but is a different disease with its own operation.
You need myomectomy when fibroids are causing symptoms or reproductive harm that medicines have not controlled — heavy bleeding with anaemia, pressure and bulk, pain, or fibroid-related miscarriage and infertility. A symptom-free fibroid found on a routine scan usually needs monitoring, not surgery.
Persistent heavy menstrual bleeding — especially with anaemia; cavity fibroids bleed out of all proportion to their size (StatPearls 2025) — see heavy menstrual bleeding.
Bulk and pressure — an enlarging abdomen, urinary frequency, pelvic heaviness from large or multiple fibroids.
Pain — cyclical or constant, including degenerating fibroids.
Recurrent miscarriage or infertility with a cavity-distorting fibroid — evaluated as part of the whole fertility picture (see recurrent pregnancy loss), not in isolation.
Rapid growth or diagnostic doubt — faster-growing or unusual masses are evaluated more urgently.
Not an indication: an incidental, symptom-free fibroid in a woman with no fertility plans — see fibroid symptoms and when to see a doctor.
Myomectomy is one option on a spectrum, and honest counselling covers the others: watchful waiting for silent fibroids; medicines and hormonal devices to control bleeding; uterine artery embolisation and HIFU as non-surgical shrinking procedures; and hysterectomy as the definitive option when family is complete and disease is severe. What myomectomy uniquely offers is removal with the uterus preserved.
Watchful waiting — for symptom-free fibroids; scan-based follow-up.
Medicines and hormonal IUD — control bleeding, don’t remove fibroids; useful as treatment or as a bridge.
Embolisation / HIFU — shrink rather than remove; suitability depends on fibroid type and fertility plans.
Hysterectomy — definitive, fertility-ending; a separate, deliberate decision — see hysterectomy surgery.
The full side-by-side — including recovery and recurrence trade-offs — is at how fibroid treatments compare.
Preparation is the same disciplined day-surgery routine for both routes: consultation with imaging, pre-operative tests, a medication review, fasting for 6–8 hours — plus correction of anaemia first, so you arrive at surgery strong. Your first consultation settles the route, the plan and the questions.
First consultation — detailed history, examination, pelvic ultrasound (3D where needed) or MRI for mapping multiple fibroids; blood tests for anaemia and hormones.
Bring all reports — blood counts, liver/kidney/thyroid tests, other pre-operative tests, chest X-ray; see preparing for surgery.
Medication changes — only with your prescriber’s consent: blood thinners (e.g. aspirin) stopped about a week before; oestrogen-containing medicines about a month before the hysteroscopic route.
Continue as usual: thyroid, blood-pressure and diabetes medicines, with anaesthetist guidance.
Route-specific: bowel preparation the night before laparoscopic surgery; hysteroscopic cases scheduled just after a period when the lining is thin. Anaemia corrected with iron — and occasionally a short hormonal course to shrink fibroids and pause bleeding first.
Report any illness before the date — fever or infection may mean rescheduling for safety.
Laparoscopic myomectomy removes wall and outer fibroids through 3–4 keyhole incisions under general anaesthesia. The 3D laparoscope gives a magnified, depth-true view; each fibroid is shelled out of its capsule, the uterine wall is stitched closed in layers, and the fibroid is extracted in a containment bag. Hospital stay is typically day-care to 24 hours.
Anaesthesia and access — general anaesthesia; small incisions near the navel and lower abdomen; the 3D laparoscope provides the visual field.
Enucleation — the fibroid is separated from its capsule with minimal blood loss; bleeding-reduction measures are used routinely.
Wall repair — the uterine muscle is sutured in layers; the quality of this repair is what future pregnancies rest on.
Extraction — the fibroid is removed via a containment bag through a keyhole (in-bag morcellation where used; incisions closed with dissolvable sutures.
Suitability — ideal for subserous and intramural fibroids up to about cm and limited numbers; very large or very numerous fibroids may need open myomectomy, and conversion to open surgery — rare, for safety — is part of every consent discussion.
Hysteroscopic myomectomy removes cavity (submucous) fibroids through the cervix — no cuts, no stitches, no scars. Under general anaesthesia (or an awake office setting for small selected cases), the cavity is distended with saline and the fibroid shaved away in strips with a bipolar resectoscope under direct vision. It is day-care surgery with return to routine in a day or two.
Access — through the vagina and cervix with a hysteroscope; small selected cases may suit office hysteroscopy.
Distension and vision — normal saline expands the cavity; fluid balance is monitored continuously — the safety discipline of this operation.
Resection — a bipolar wire loop shaves the fibroid into strips removed through the cervix; bipolar-in-saline is the modern safety standard.
FIGO type 2 fibroids (more than half within the wall) — removed as far as safely presents; when the wall component will not deliver, completion happens in a planned second short sitting rather than deep cutting (StatPearls 2025).
End of procedure — cavity inspected, bleeding points controlled; no incisions to heal.
Recovery depends on the route. Hysteroscopic: home the same day, routine within a day or two — there is no wound. Laparoscopic: day-care to 24-hour stay, light activity in about a week, work in 7–10 days, full healing over 4–6 weeks. Both are mapped week-by-week in the recovery guide.
Hysteroscopic route: ~2 hours in recovery; liquids at 1 hour; walking once steady; same-day discharge; mild cramps and spotting for a few days; routine in 1–2 days.
Laparoscopic route: walking within 24 hours; incisions kept clean and dry; no strenuous activity for ~3 weeks; desk work in 7–10 days; full healing 4–6 weeks; medications as prescribed.
Both routes: periods may differ for a cycle or two; follow-up review before returning to intercourse and exercise.
The detailed timeline — day by day, week by week — is in the recovery week-by-week guide.
Expect real relief of the symptoms the fibroid was causing: heavy bleeding usually improves markedly once a cavity or wall fibroid is out, and bulk, pressure and pain settle as the uterus returns towards normal size. On fertility, honesty matters: removing a cavity-distorting fibroid is a reasoned, recognised step — but the research evidence that myomectomy improves live-birth rates is uncertain, and no ethical surgeon promises a pregnancy.
Bleeding control — the most reliable gain, particularly after removing cavity fibroids.
Pressure and pain relief — as bulk resolves.
Fertility, stated straight: the Cochrane review (4 RCTs, 442 women, 2020) found it uncertain whether myomectomy improves clinical pregnancy or live birth — very low-certainty evidence. Cavity-distorting fibroids remain a recognised, correctable factor, and the decision is made within a full fertility evaluation — see also fibroids, fertility and pregnancy and the IVF planning context.
Recurrence, stated straight: the removed fibroids do not regrow, but new fibroids can form in a uterus prone to them; follow-up scans keep watch where indicated.
Myomectomy is routine surgery in experienced hands, and serious complications are uncommon — but each route has its own specific risks that deserve plain words before consent. Laparoscopic: bleeding, infection, adhesions, organ injury, conversion to open surgery, and — rarely — hysterectomy for uncontrollable bleeding. Hysteroscopic: perforation, fluid overload, adhesions, and staged resection for deep fibroids.
Both routes: anaesthesia-related problems (screened beforehand); bleeding; infection.
Laparoscopic-specific: adhesion formation in the pelvis; injury to nearby organs; conversion to open surgery when safety demands; and the rare, honest consent point — hysterectomy for uncontrollable bleeding — preserved from the original page because patients deserve to know it exists.
Hysteroscopic-specific: uterine perforation (~0.76%); fluid overload (prevented by continuous monitoring); intrauterine adhesions — treatable if they form, see Asherman’s syndrome; planned second-stage resection for FIGO type-2 fibroids (StatPearls 2025).
For future pregnancies: a uterus whose wall was incised and repaired needs its obstetric team informed; depending on the depth of repair, a planned caesarean delivery may be advised. Your specific risks are discussed individually before consent — number, size and position of fibroids change the conversation.
Myomectomy cost depends on the route, the number and size of fibroids, and room category. Indicative figures below are exclusive of room category and GST, and are confirmed in writing after consultation — beware of any site quoting one flat number for every case.
| Procedure | Indicative range (₹) |
|---|---|
| Gynaecology consultation | from ₹1,000 |
| Ultrasound / MRI mapping | ₹2,500 – ₹12,000 |
| Hysteroscopic myomectomy (cavity fibroids) | ₹60,000 – ₹1,00,000 |
| Laparoscopic myomectomy (wall/outer fibroids) | ₹75,000 – ₹2,50,000 |
| Combined sitting (both routes) | ₹1,00,000 – ₹2,50,000 |
| Planned second-stage hysteroscopic resection | ₹40,000 – ₹80,000 |
The wider cost picture across all fibroid treatments is on the fibroid treatment costs page
Dr. Dimple Doshi (MBBS, MD, DGO) is a gynaecologist and laparoscopic surgeon with 27+ years’ experience and 20,000+ surgeries performed, practising at Vardaan Hospital, Goregaon West, Mumbai — with both myomectomy routes under one roof, so the operation is matched to the fibroid rather than to the only tool available.
500+ patients treated with laparoscopic myomectomy — and 50+ with the no-incision hysteroscopic route.
3D laparoscopy — depth-true vision for shelling fibroids and suturing the wall in layers.
Route-matched, not one-size — cavity fibroids never get keyholes they don’t need; wall fibroids never get a resectoscope that can’t reach them.
Honest counselling — fertility expectations, recurrence, and the rare-conversion consent points discussed before, not after.
For insurance and mediclaim paperwork, the diagnosis is coded under ICD-10 D25 (leiomyoma of uterus), with the sub-code by position — which conveniently mirrors the route decision on this page. American CPT codes are not used for Indian billing.
D25.0 submucous (→ hysteroscopic route) · D25.1 intramural · D25.2 subserosal (→ laparoscopic route) · D25.9 unspecified.
For US reference only (collapsed block if kept): CPT 58561 (hysteroscopic myomectomy) · 58545/58546 (laparoscopic, by number/weight) · 49320 (diagnostic laparoscopy) · 58140 (open myomectomy).
Ans. Yes — that is exactly what myomectomy is. Fibroids are removed hysteroscopically (through the cervix) or laparoscopically (through keyholes), and the uterus is preserved and repaired. Hysterectomy is a separate, deliberate decision for completed families with severe disease — never the default.
Ans. Neither is “better”; they treat different fibroids. Cavity (submucous) fibroids need the hysteroscopic route; wall and outer fibroids need the laparoscopic route. Women with both kinds get a combined plan. Your scan report already contains the answer.
Ans. Often yes — wall fibroids in the range of cm can be removed laparoscopically depending on number, position and access. Very large or very numerous fibroids may be better served by open myomectomy, decided openly before surgery rather than mid-operation.
Ans. Hysteroscopic myomectomy leaves no scars at all — it happens through the natural passage. Laparoscopic myomectomy leaves 3–4 small keyhole marks that fade well. Neither involves the long incision of open surgery unless a rare conversion is needed for safety.
Ans. Hysteroscopic: same-day discharge, routine in 1–2 days. Laparoscopic: day-care to 24-hour stay, light activity in about a week, work in 7–10 days, full healing over 4–6 weeks. The week-by-week guide maps the whole arc.
Ans. After the hysteroscopic route, commonly 1–3 cycles once healing is confirmed. After laparoscopic myomectomy, most surgeons advise 3–6 months so the uterine wall repair matures before it carries a pregnancy. Your interval depends on the depth of repair.
Ans. The honest answer: removing a cavity-distorting fibroid is a recognised, reasoned step, but research evidence that myomectomy improves live-birth rates is uncertain (Cochrane 2020). Fertility is evaluated as a whole — fibroid, tubes, ovulation, partner — and no ethical clinic promises a pregnancy from any single operation.
Ans. The removed fibroids do not return, but new ones can form in a uterus prone to them — more likely with multiple fibroids and younger age at surgery. Follow-up scans keep watch; a recurrence is not a failed operation.
Ans. The cavity is expanded with saline, and some can be absorbed into the circulation. It is prevented by counting every millilitre in and out and keeping operating times disciplined — one of the two specific risks (with perforation, ~0.76%) your team actively guards against.
Ans. A FIGO type-2 fibroid sits more than half within the wall. Removing what presents and completing the rest in a planned second short sitting is safer than cutting deep into the wall in one go. It is a strategy, not a complication.
Ans. Very rarely, uncontrollable bleeding during myomectomy is managed by hysterectomy as a life-safety measure. It is a standard consent point, discussed before every myomectomy — and its rarity is exactly why it belongs in an honest conversation rather than in small print.
Ans. Not automatically. It depends on how deeply the uterine wall was incised and repaired; your obstetric team — fully informed of the operation — decides the delivery mode. After hysteroscopic myomectomy the wall is not cut, so it does not by itself change delivery planning.
Ans. They both involve the uterus, but differently: a C-section opens the uterus to deliver a baby; a myomectomy removes fibroids and repairs the wall in layers. Recovery, implications and purpose all differ.
Ans. After the laparoscopic route: heavy lifting, strenuous activity and intercourse for roughly 4–6 weeks while the wall repair matures. After the hysteroscopic route: intercourse and swimming until your review clears them. Both: don’t ignore fever, worsening pain or heavy bleeding — call the clinic.
