The short answer
Which type of myomectomy you need depends mainly on where your fibroids are, how many there are and how big they are. Fibroids inside the cavity of the womb can often be removed through the vagina by hysteroscopy, with no cut. A few moderate fibroids may suit keyhole surgery, and many or large fibroids usually need an open operation through a cut low on the tummy.
Book a myomectomy, from ₦1,000,000Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Where the fibroid sits decides most of it
Your scan report describes each fibroid's position. Submucosal fibroids bulge into the cavity of the womb. Intramural fibroids sit inside the muscle wall. Subserosal fibroids grow on the outside surface, sometimes on a stalk. A pelvic scan, and sometimes an MRI, lets the surgeon map them before deciding on the approach.
Hysteroscopic myomectomy: through the vagina
A thin telescope passes through the vagina and cervix into the womb, and the fibroid is shaved away from the inside. There is no cut on the tummy. It is usually a day case, and most women are back to normal activities within a few days.
It suits smaller fibroids that sit mostly inside the cavity. Larger ones sometimes need two sessions. It cannot reach fibroids deep in the wall or on the outside.
Laparoscopic myomectomy: keyhole
The surgeon works through a few small cuts on the tummy using a camera and long instruments. The fibroids are removed, and the womb is stitched from the inside of the tummy. Recovery is usually quicker than open surgery, with less pain and smaller scars.
It suits a limited number of fibroids that are not too large. It takes particular skill, especially for stitching the womb, and not every surgeon offers it. Removing large fibroids through small cuts may involve cutting them into pieces inside the body; ask your surgeon how they do this and what the risks are for you.
Open (abdominal) myomectomy
The surgeon makes a cut on the tummy, usually a low 'bikini line' cut, sometimes a vertical one for a very large womb. Open surgery lets the surgeon feel for small fibroids and remove many fibroids at once, and stitch the womb in careful layers.
It is the most common approach for multiple or large fibroids. It means a longer hospital stay, usually a few nights, and around six weeks before you feel close to normal.
Questions to ask your surgeon
- Which approach do you recommend for my fibroids, and why?
- Do you offer the other approaches, and would they be possible for me?
- Could you have to switch from keyhole to open during the operation?
- How will you reduce bleeding, and how much blood should I build up first?
- Will my next birth need to be a caesarean after this operation?
What it costs on Mezo
Two units of blood cross-matched and available are included.
Common questions
Is laparoscopic myomectomy better than open?
It is not better for everyone. It usually means a quicker recovery, but it suits fewer, smaller fibroids. For many large fibroids, open surgery is often the safer and more complete operation.
Can all fibroids be removed through the vagina?
No. Only fibroids that sit mostly inside the cavity of the womb can be removed by hysteroscopy. Fibroids in the wall or on the outside need keyhole or open surgery.
Will I have a big scar?
An open myomectomy usually leaves a low scar along the bikini line that fades with time. Keyhole leaves a few small scars, and hysteroscopy leaves none on the skin.
What does fibroid removal cost on Mezo?
A myomectomy is from ₦1,000,000 and a hysteroscopy is from ₦300,000. The written all-in quote follows the assessment and the scan, because the approach changes the operation.
The procedures
Related health guides
More patient guides
Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Fibroids. NHS. Patient information.
- Laparoscopy (keyhole surgery). NHS. Patient information.
- Hysteroscopy. NHS. Patient information.
Links last checked 22 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.