Vasectomy Postoperative Counseling

Aka: Vasectomy Postoperative Counseling

advertisement

II. Management: General

  1. Clinic Follow-up
    1. Postoperative Care Handout describing below
    2. Call patient to check on status on day 1 or 2 post-op
  2. Analgesics
    1. Wear athletic supporter (jock strap) for first 3-4 days
    2. Medications
      1. NSAID (e.g. Ibuprofen) and Acetaminophen as base post-operative Analgesics
      2. Opioids (e.g. Oxycodone) are NOT typically needed
        1. Barham (2019) J Urol 202(4): 806-10 [PubMed]
  3. Contraception
    1. Continue reliable Contraception until semenanalysis confirms sterility

III. Management: Postoperative Activity

  1. Off Work for 1-3 days
    1. Day 1: Supine with ice on Scrotum for 20 minutes/hour
    2. Day 2: Minimal activity but patient may shower
    3. Day 3: Activity as tolerated
    4. Avoid ejaculation or sex for the first week after Vasectomy
  2. Limited activity for 2 weeks
    1. No strenuous Exercise or risk of local Trauma
    2. Sexual activity no more than twice per week

IV. Indications: Call office

  1. Pain not relieved with Analgesics given
  2. Scrotal Swelling beyond expected
  3. Persistant scrotal Bruising beyond 2 weeks
  4. Stitches still present beyond 2 weeks after procedure
  5. Signs of scrotal infection
    1. Redness
    2. Swelling
    3. Tenderness
    4. Fever
    5. Pustular discharge from incision site

V. Labs: Post-Vasectomy Semen Analysis

  1. Findings with successful Vasectomy
    1. Median time to loss of Sperm Motility: 3 weeks
    2. Median time to azoospermia: 10 weeks
    3. Rare non-motile sperm after 12 weeks
  2. Precautions
    1. Non-compliance with post-vasectomy Semen Analysis is common (up to 19% fail to return with sample)
  3. Sample timing
    1. Obtain first sample at 3 months and at least 20 ejaculations after Vasectomy
    2. Some recommend sample be obtained after 2-7 days of abstinence to increase Test Sensitivity
    3. Bring sample to lab within 1 hour of ejaculation (keep sample close to Body Temperature)
    4. Centrifuged sample should be examined within 2 hours of ejaculation
  4. Persistent non-motile sperm on initial 3 month sample
    1. Repeat Semen Analysis monthly until
      1. No sperm on at least one sample OR
      2. Less than 100,000/ml non-motile sperm on 2 consecutive samples at 7 or more months since Vasectomy
  5. Persistent motile sperm on initial 3 month sample
    1. Suspect failed Vasectomy
    2. Confirm motile sperm present on repeat Semen Analysis in one month
    3. Repeat Vasectomy if motile sperm confirmed on second sample

VI. References

  1. Arnold (2025) Am Fam Physician 112(3): 264-9 [PubMed]
  2. Pfenninger (1984) Am Fam Physician 30(4):177-84 [PubMed]
  3. Rayala (2013) Am Fam Physician 88(11): 757-61 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Vasectomy Postoperative Counseling." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Topics in Procedure

advertisement