- Location often matters more than size.
- Submucosal fibroids can be removed through the vagina.
- The FIGO system guides surgical planning.
The three main types
Submucosal: bulge into the cavity — cause heavy bleeding and fertility problems even when small. Intramural: within the muscle wall — cause pressure and heavy periods when large. Subserosal: on the outer surface — usually pressure symptoms on bladder, bowel or back rather than bleeding.
The FIGO classification
Modern practice uses the FIGO 0–8 system to describe exactly where each fibroid sits. This matters because a FIGO 0–2 fibroid can be removed hysteroscopically (through the vagina, no cuts) whereas higher types need laparoscopy or open surgery.
Frequently asked questions
Do submucosal fibroids need removing?
Almost always if they cause heavy bleeding or affect fertility.
Can subserosal fibroids affect pregnancy?
Rarely, unless very large or on a stalk that could twist.
How is the type identified?
Transvaginal ultrasound or dedicated MRI.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your imaging and giving you a clear personalised plan for uterus-sparing fibroid surgery.
Request a video consultation