Facing gynecologic surgery can feel overwhelming — but you’re not alone, and you have options. Every case is different, and understanding your treatment choices is an important step toward feeling confident in your care.
Experts from Atrium Health Wake Forest Baptist women’s health share what to expect before, during and after surgery — and how to feel supported every step of the way.
Know Your Options
If you’re dealing with pelvic pain, fibroids, abnormal bleeding, endometriosis or another gynecologic condition, there are often several ways to treat it, and surgery may be just one option.
For example, endometriosis may require surgery to remove tissue growing outside the uterus — especially when other treatments, like hormonal therapy, haven’t helped. But surgery should be part of a long-term care plan that includes open discussion and follow-up.
Dr. Eva Maria Reina, a gynecologic surgeon at Atrium Health Wake Forest Baptist Center for Fertility and Reproductive Surgery, says there’s no one-size-fits-all solution.
“We tailor each approach based on the patient’s symptoms, goals and concerns,” Reina says. “For endometriosis, we may use advanced laparoscopic techniques, but we also look at the whole picture.”
That kind of holistic approach helps patients understand not just what the surgery will do, but also how it fits into their larger health journey. Dr. Cassandra Hornbuckle, an OB-GYN at Atrium Health Wake Forest Baptist Obstetrics and Gynecology Wilkes, says it’s not just about choosing a surgery. It’s about making sure the patient understands what symptoms may improve, what side effects to expect and how recovery might feel.
As you navigate your treatment options, Reina encourages open conversations with your provider to find what’s best for you.
“The first question to consider is whether preserving fertility is a priority,” Reina says. “Outside of hysterectomy, there are many options, including medication, ultrasound-guided procedures and radiofrequency ablation.”
Hornbuckle emphasizes the importance of setting realistic expectations.
“Surgery can bring relief, but it’s important to understand how much improvement to expect in the long-term. If discomfort lingers, reaching out early allows us to adjust medications or explore other solutions.”
Understanding your options is just the beginning. Having the right support team can make all the difference.
Know Your Care Team Has You Covered
Successful surgery doesn’t happen in isolation — it takes a coordinated team.
From anesthesiologists and nurses to pelvic floor therapists and primary care doctors, multiple professionals may be involved in your care before, during and after surgery. That’s especially true if you have other health conditions that need to be managed along the way.
Dr. Janelle Moulder, a gynecologic surgeon at Atrium Health Wake Forest Baptist Center for Fertility and Reproductive Surgery, says some patients may not realize how much coordination happens behind the scenes.
“We’re looking at everything, your health history and the steps that set you up for a smooth procedure, so no one is left without support,” Moulder says.
That support can extend across hospitals, clinics and communities.
“Sometimes the best thing for a patient is to be seen closer to home, or to work with a different specialist,” Hornbuckle says. “We share patients across locations so they can get the care they need, wherever they are.”
Know What To Expect
Surgery isn’t just about the procedure itself, it’s about feeling prepared. Knowing what to expect at each stage can ease concerns and make recovery smoother.
Preparing for Surgery
Your care team should walk you through every step of the process, not just what the surgery is, but how to prepare your body and your routine.
Moulder says things like blood pressure and underlying conditions can affect surgical risk.
“When we talk about those things early, it’s not about judgment, it’s about keeping you safe and making a plan together,” Moulder says. “This may include managing blood pressure, weight or chronic conditions in the weeks leading up to surgery.”
You'll also receive instructions about medications to avoid, when to stop eating before surgery and what to bring or arrange for the day of the procedure.
As you prepare for surgery, it can be helpful to jot down a few questions for your doctor. Asking questions isn’t just about getting answers, it’s about feeling informed, supported and ready for the next step.
During Surgery
Many gynecologic procedures today are less invasive than in the past, but it’s still surgery, and it’s completely normal to feel apprehensive. Hornbuckle reassures her patients that those feelings are valid.
“Nervousness can be a good thing,” Hornbuckle says. “It means you understand what’s happening and you’re taking it seriously. That’s when we get to step in and say: ‘You’re not alone. We’ve got you.’”
Even with minimally invasive techniques — like those often used in endometriosis surgery — the procedure can be complex, especially when removing tissue close to areas like the bladder or bowel.
“Just because we’re doing it through a smaller incision doesn’t mean your body doesn’t need time to heal,” Moulder says. “Setting the right expectations up front is so important.”
Recovering From Surgery
Recovery can feel different than expected and knowing that ahead of time makes it easier to adjust.
“When we talk with patients about recovery, we explain things like referred shoulder pain from the gas used during laparoscopy, or why fatigue can last beyond four weeks,” Hornbuckle says. “Knowing these things ahead of time helps patients feel less anxious if it happens.”
For people with endometriosis, it’s also important to talk about long-term plans, like ongoing medical therapy, fertility considerations and how to manage any recurring symptoms. That kind of planning can start before surgery and continue well into recovery.
When it comes to gynecologic surgery, whether it’s for endometriosis, fibroids or something else, it’s not just the procedure that matters. It’s the support you receive at every step. You deserve to have your questions answered, your values respected and your care tailored to you.
Wondering what your surgical options are? The more you know, the more confident you’ll feel in choosing what’s right for you. Start by having a conversation with an OB-GYN or gynecologic specialist.