Fibroids that protrude into the cavity of the uterus are called sub mucosal fibroids and can certainly be a cause of irregular, heavy and prolonged bleeding. They may also cause intramenstrual and post coital bleeding.
Fibroids that are sub mucosal should be resected prior to couples undertaking fertility treatment and resected if causing menstrual problems. This operation is performed by means of an operation called Hysteroscopy with trans cervical passage of a special instrument that shaves off the fibroid within the uterus. This is usually performed as a day case procedure and sometimes requires suppression of hormones prior to the surgery being undertaken, depending on the size of the fibroid.
Intramural fibroids can be removed by means of either an open procedure called an open myomectomy or a laparoscopic procedure called a laparoscopic myomectomy. The type of operation performed depends on the size of the fibroids and their location.
It is only usually recommended to remove fibroids that have reached at least 5 cms for fertility problems. Fibroids that are also causing pressure problems should be removed.
Fibroids can be easily diagnosed by ultrasound scanning, although occasionally MRI scanning can be of value in locating and establishing the size of multiple fibroids.