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When your health care provider informs you that surgery is a recommended treatment option, there are a number of decisions for you to make. These include whether to have surgery at all, and if so, when to schedule it, and whom to choose as your surgeon. Typically, several options are available before surgery must be seriously considered. Generally, surgery should be considered only after more conservative measures have been exhausted. Though it may be tempting to take the last step first, because surgery may seem like the most definite solution, you need to remember that surgery may not be the only answer. Every procedure has risks and no surgeon can guarantee a good outcome.

Because most conditions are not emergencies, alternatives to surgery are often good choices. One alternative may be watchful waiting to see if a condition improves or worsens on its own. Small fibroids that cause no symptoms may need no treatment at all. Fibroids shrink after menopause, so a woman who is close to menopause may try waiting to see if her symptoms subside once she stops menstruating. Fibroids and abnormal uterine bleeding may also be treated first with hormones or with minimally invasive surgery. By choosing to wait or investigating other options women may be able to postpone surgery indefinitely.

Once the decision to have surgery has been made, a woman should have a clear idea what is treatable by surgery and what is not. For some women, having too much detailed information about an impending operation is stressful. Still, a woman needs to be informed enough about the surgery to tell the surgeon what she wants done and what her wishes are in the event of unexpected findings.

Surgeries are designed to relieve symptoms, diagnose a condition, or to extend life. Having a good understanding of the procedure beforehand can make surgery less stressful and result in a better outcome. The informed woman should ask her health care professional what precisely an operation is meant to do, and if something is going to be removed, you should know why exactly.

If an operation can be done more than one way, a woman can weigh the benefits of having a less invasive procedure. A woman should ask the surgeon whether the procedure she is considering is one he or she does frequently, or only on occasion. Often, a surgeon who is used to doing a procedure a certain way and has performed a lot of them has better results.

You should also discuss possible complications such as infection, bleeding, or reactions to anesthesia. Knowing what to expect after surgery allows you to feel more in control and better able to cope with recovery. Getting answers to certain questions can help. Ask:

• how will the surgery improve my health or quality of life?

• will I have vaginal bleeding or discharge after surgery?

• where will the incision be and will I have a visible scar?

• how long can I safely delay the surgery?

• who will be in the operating room during surgery?

• will more surgery be necessary?

• what presurgical tests are necessary?

• what can I expect during recovery?

• where will the operation be done?

• what type of anesthesia will be used?

• when can I resume my normal activities?

• what, if any, limits will I have after surgery?

Developing a good relationship with your treatment team can help you feel more comfortable about your treatment and the outcome of your surgery. Some physicians are better communicators than others. Look for a physician who is:

• patient and approachable

• forthcoming with information

• a good listener

• willing to address your concerns

• competent and experienced

• has a team in place that shares these traits and is willing to help you if you ask

Getting a second medical opinion on any medical recommendation, if possible, can help make your options clearer to you. The advice of another health care professional can:

• verify your diagnosis

• ensure that all other forms of treatment have been explored

• satisfy health insurance requirements

• be a source of more information

A competent health care professional should not be insulted if you decide to get further advice. Sources for finding a medical expert to provide a second opinion include your primary health care provider-ask him or her to refer you to another; family or friends who have had success with a particular health care professional; and a local medical society or national association of specialists. Your health insurance coverage may require a second opinion and require you to choose from its list of providers.