NSV - The Book - 005

After the Vasectomy

Typically there is mild discomfort for 5 to 10 days. It’s usually in the scrotum, but it may radiate to the groin or even the lower abdomen (Up in the ovaries like a menstrual cramp!). It can be one-sided or bilateral. Swelling is usually mild. It often only starts on the third or fourth day. That’s why you need to follow instructions whether you think you need to or not.

Following these instructions carefully will ensure the best prospect for an uneventful recovery.

Activity:

Go straight home and do as little as possible for the rest of the day, and the next. No yardwork! No driving range! No lifting the baby! No horsing around with the kids! Nothing! I mean it.

Yes you can go to the bathroom but only if you absolutely have to (joke). You can increase your activity gradually day by day, but remember to always err on the side of caution. Exertion at work or sports, and sexual activity are best avoided for a full week. Lift nothing over 15 lbs for the first three days and nothing over 50 pounds for the rest of the week. If in doubt, don’t do it!

Sexual activity should also be avoided for the first week. If anything comes up just ignore it and it will go down again.

Ice:

Apply an ice pack over the gauze and athletic support as soon as you get home and ice as much as possible over the next few days. A dozen ice cubes (give or take) in a waterproof plastic bag is undoubtedly the cheapest and probably the best. It will take a while for the cold to penetrate all the gauze, but you’ve got lots of time. You don’t want to freeze it, you just want to keep it cool.

Wound care:

The small wound is sealed with skin adhesive so there is no mess or bother. There should be no seepage or bleeding from the wound. Still, have a peek every once in a while to make sure all is well. The gauze is just to keep some pressure on the wound for the first few days. It also elevates and protects the scrotal contents from the forces of gravity. Take the strap and gauze off in the morning and have a gentle shower. Each day throw away one or two pieces of gauze closest to the skin before you step back in, so that the gauze pack is dwindled down to nothing over time. Once the gauze is gone you may want to keep using the support. If so, wear it outside your underwear to avoid the rough cloth on tender skin. The support, with or without gauze should cradle things nicely out of the way. We don’t want your testicles hanging down and banging around.

Alcohol:

No drinking for at least the first 48 hours post-op. Alcohol can thin the blood and/or cloud the judgment. Don’t risk it. Not only should you not drink, you should also stay away from drunks.

Pain and its management:

We provide you with ibuprofen 600 mg, 3 times a day for a week. This is not just for pain. It also prevents inflammation. Typically a mild delayed inflammatory reaction begins around the third or fourth day and results in some swelling and pain around the vasectomy site, above the testicle on one side or the other, occasionally both. This is your cue to take it easy and d more icing as necessary. People who get stomach upset from ibuprofen can substitute an anti-inflammatory like Celebrex. Those allergic to ibuprofen or aspirin can substitute acetaminophen if necessary. Remember, swelling is what this part of the anatomy prides itself in doing best so take that anti-inflammatory for the full week whether you think you need it or not.

If there is:

  • Fever
  • Pain worse than a “3 out of 10”
  • Swelling larger than a grape.
  • Bruising under the skin is no great concern unless it is swollen or painful.
  • Blood in the semen can occur in the first few ejaculations and is of no concern. You shouldn’t be messing around yet anyways!

Follow-up visit:

I’d like to see you back for a brief follow-up in 5 to 14 days if possible. I check on healing, have you fill out a brief questionnaire and review your next assignment… semen testing in 6 weeks. Don’t forget the backup birth control until we’ve done the test to ensure the vasectomy worked. (The proof’s in the pudding!)

Rich’s rules for an uneventful recovery:

  • Go straight home and sit with your feet up as much as possible for the first few days.
  • No lifting, straining, exerting or excessive walking for the first 3 days. A desk job can be resumed in 48 hours but more strenuous work should be avoided for up to a week.
  • No ejaculation for a week. If you don’t follow this one you void the warranty. (Just kidding, there is no warranty.)
  • Ice the scrotum, through the gauze, as much as possible for the first 2 or 3 days.
  • FEVER, BLOOD, PUS, SEVERE PAIN OR SWELLING? These are not normal.
  • Call me if this happens. (You will get my cell phone number at surgery.)
  • Arrange for a post-op visit in 5 to 14 days.

If everything is fine after the recheck you may resume your normal activities but use common sense. Start low and go slow. Complete healing can sometimes take up to a month.