II. Management: Clinic Follow-up

  1. Postoperative Care Handout describing below
  2. Call patient to check on status on day 1 or 2 post-op

III. Management: Analgesics

  1. Wear athletic supporter (jock strap) for first 3-4 days
  2. Medications
    1. NSAID (e.g. Ibuprofen) for daytime use
    2. Consider Opioid (e.g. Hydrocodone with Acetaminophen) for night pain

IV. 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
  2. Limited activity for 2 weeks
    1. No strenuous Exercise or risk of local Trauma
    2. Sexual activity no more than twice per week

V. 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

VI. 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. Three months and at least 11-20 ejaculations after Vasectomy
    2. Obtain sample 2-7 days following abstinence and keep sample at Body Temperature bring to lab within 1 hour
  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

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