It is important to read all the information carefully and keep a note of the link to this page for reference. These instructions are written in the past tense for those who have already undergone the procedure, however it is important to understand this information pre-operatively too if you have been sent this link advance.

Your Procedure and What to Expect

You have undergone a no-scalpel vasectomy under local anaesthetic. A single incision was used. The tubes on both sides were accessed through this one incision. The skin may have been cauterised to prevent bleeding and sometimes can look like a small burn.

Skin Healing

After a few days the very surface of the skin at the incision site may become slightly yellow and soft and come away after a few days, this is more likely to happen if you had to have a little more cautery to stop any bleeding. As long as there is no redness, heat, pain, swelling and you do not have a fever or feel unwell there is no reason to worry.

Anaesthetic and Pain Relief

The anaesthetic will wear off in a couple of hours. You may feel a little sore at this point, but to avoid this we suggest you take some painkillers such as paracetamol or co-codamol from the pharmacy within the next two hours and take them regularly for a few days as long you have no allergy and there is no other reason not to take them.

If you experience pain after the first few days with no redness, heat, significant swelling and you do not have a fever or feel unwell we suggest that, as long as you have no allergy to or other reason not take anti-inflammatories you take an anti-inflammatory painkiller regularly, such as Ibuprofen 400mg three times a day for 2 weeks. It would also be helpful to apply ice packs, or a bag of frozen vegetables wrapped in a clean tea towel in the evenings for this period.

Bruising

Some men get a little bruising under the skin of the scrotum and in some individuals the bruising can be extensive. This usually does not cause much by way of discomfort and does not usually cause or represent a problem and should fade away over several weeks.

Post-Operative Care Instructions

First 48 hours

It is essential that you go straight home after vasectomy and rest completely with your feet up for the first 24 hours and do very little. Keep your supportive underpants on overnight – this gives the area support and keeps the dressing in place. As soon as you get home we advice ice packs to cool the area. We suggest 10 minutes on and 5 minutes off. Cycle that for one and a half hours then take a break for an hour or so and repeat. Keep repeating the day of surgery. You can repeat this the following few days too. Cooling the area with an ice pack or a bag of frozen vegetable in a clean towel can be helpful in the healing process as well as helping to reduce pain, swelling and blood collection formation.

For the second 24 hours avoid any prolonged standing or walking, and if at all possible, rest completely for this period also.

Avoid alcohol for the first 48 hours.

Bathing

Soaking in a bath should be avoided until the skin has healed or scabbed over, which should be about a week to ten days. You can have a shower after 24 hours but avoid agitating the scrotum for the first week as this can risk pulling the skin apart or cause bleeding. Use clean underpants daily, have a shower every day and have a clean towel every day. This all helps healing and keeps infection at bay.

Sexual Activity

We recommend that you avoid sexual activity for the first week to reduce the risk of developing small blood clots or causing other injuries. After that you may resume sexual activity when you feel comfortable. You may notice a little blood in the semen (fluid) – this is quite normal and not anything for you to worry about, it may even occur after two to three months, until all the old sperm is ejaculated. Any blood will gradually fade with time.

It is essential that during the next four months you have a regular sexual relationship in order to clear the stored sperm BUT remember that during this time you are still fertile and quite able to create a pregnancy so you must continue to use contraceptive precautions, until after you have had a “clearance letter” from us.

Driving

You are not to drive for 24 hours following your vasectomy as there have been rare cases of people passing out due to a delayed reaction to the anaesthetic. Driving after 24 hours is fine provided comfort allows and pain does not distract from concentration. However, try to avoid journeys of longer than an hour or split journeys up into 1-hour sections for the first week. This is to avoid the area becoming too hot and sweaty which in turn may increase the risk of infection or bleeding.

Sports

Avoid sports and exercise, including cycling, rowing, running, weightlifting, hiking and golf for at least two weeks after the operation. Contact sports and heavy physical exercise should be avoided for 4 weeks. The reason for this is that leakage from the small blood vessels is more likely which can induce haematoma or persistent pain.

Work and Heavy Lifting

Please avoid heavy lifting for at least two weeks following the procedure. If your job does not involve any heavy lifting or much manual work, you can normally return to work after a few days. However, if your job involves heavy lifting or manual work you will need to have light duties for at least two weeks.

Possible Complications

If you have any of the problems below, please follow the steps suggested but if you go to see a doctor other than your vasectomy surgeon please show them this information.

Infection

If the wound or scrotum becomes very painful, red, swollen or tender and you have fever or there is pus coming from the wound you should contact us or see your own GP straight away. If you develop these systems out of hours or at a weekend, then please call 111 for advice on who to see. Please remember that, as mentioned earlier, a small amount of yellow material can ‘slough’ away from the skin in the first few days after the procedure.

Bleeding from the Skin

Occasionally a small amount of bleeding can occur from the skin, if this occurs use the supplied gauze material to firmly pinch the scrotal skin between the thumb and fingers for 10 minutes using a watch or clock to time it. This process can be repeated as needed but if the bleeding persists please contact us or see your GP straight away. If this occurs at the weekend or out of hours and there is slight oozing of blood, then call 111 for advice. If, however there is significant bleeding please go to A&E.

Blood Clot

Occasionally a small blood vessel can bleed inside the scrotum which can result in a blood clot known as a haematoma. If there is a cricket ball sized swelling in the scrotum which occurs within a few days to a week, please contact us or your own GP. If this is not enlarging it may just be observed by us or your GP for a little while. Sometimes anti-inflammatories are prescribed for this. Some doctors may prescribe antibiotics, but this is not an infection and usually antibiotics are not needed. If this occurs out of hours or at the weekend but is not enlarging, you can wait until we or your GP are available to contact but if it continues to enlarge please go to the A&E department. Most haematomas will simply settle down and some cause discomfort and very occasionally they need to be drained.

Pain

Some people may have some initial surgical pain, normally lasting no more than a few days. However, during the healing process further pain or ache can develop. This can come on after four to five days and may on occasion prevent work. This usually settles down within two weeks but occasionally goes on for six to eight weeks or more. Regular anti-inflammatories (as discussed earlier in this booklet) along with ice packs in the evenings may help to alleviate this. Individuals who are still in significant discomfort after eight weeks or are concerned before this time, please contact us directly for further advice.

Prolonged pain as part of the post-vasectomy pain syndrome (pain lasting 6 months or more) is quite uncommon in our experience but has various rates quoted on the internet and in literature. If you have concerns that you are suffering with this, please contact us directly.

Other Problems

If you feel you are suffering any problems mentioned before the procedure or you need advice or have concerns please feel to contact us – we are more than happy to give you advice over the phone or see you for a review appointment if you wish.

Semen Testing

Your specimen is due to be sent four months after the operation. Please do not send a sample prior to that. You must wait until after this date as this is the period of time in which there is the greatest risk of the tubes re-joining.

Remember that it takes a minimum of 25 ejaculations to clear the sperm from the system (and in some cases more), or if you have a period of sexual inactivity after your operation, you may need to postpone the dates of your test as you may not have cleared the system.

Semen analysis is performed by AccuLabs. You have been provided with containers, a form and a pre-paid postal bag so you can post the specimen directly to the laboratory. Please call our secretaries on 01902 859902 for any questions you may have regarding this.

Specimens should be collected in the smaller container provided and produced by masturbation only to avoid contamination. Please mark the date and time the sample was produced clearly on both the bottle and on the form. Please put the smaller container (containing the sample) into the plastic specimen bag and seal it shut according to the instructions on bag. In some cases you may have a larger, outer container instead of the plastic bag – in which case please place the sample pot into the larger pot and close that tight too. Once the sample pot is placed in the appropriate outer covering, it should be placed in the outer cardboard box. You should also place the the completed request form into the cardboard box too.The cardboard box containing the double potted sample, and the request form, is then placed in the plastic, postage pre-paid envelope. This will be explained to you on the day. It is important that the sample is produced the same morning as it is sent to the laboratory, and you should avoid posting on bank holidays, weekends and during any periods that the post may be delayed. You should also ensure that you have 2-5 days of abstinence before you produce your sample. Under no circumstances should you send the sample before the 4 months is complete.

You should receive notification of the results within a fortnight of sending in the specimen. You may get a link to obtain your result online or you may receive it by post. Unfortunately, postal delays can increase the timeframe in which you receive the results and so on rare occasions results can take longer than two weeks. If you have not had your result in this time, please call so we can look into this for you. We regret that we cannot give results out by telephone; this is for confidentiality reasons and to avoid the risk of error. Please let us know if your address changes after your operation.

If your sample is clear according to current guidelines you will you will receive a letter confirming sterility, however if sperm persist you will be required to do further tests. According to current guidelines if a very small number of non-motile sperm are present in a fresh sample, you can be given ‘clearance’ as the risk of pregnancy is the same as if no sperm were present. However, as this is a postal sample we cannot be sure of the motility of the sperm and so if sperm are present you will be given the option to repeat a postal sample or to take the sample directly to a different laboratory.

If at any stage we feel that your operation has not been successful, we will tell you at once, and of course we will perform a reoperation at no cost in the very rare cases where one of the tubes re-joins.

UNTIL YOU RECEIVE THE “ALL CLEAR” FROM US, WE STRONGLY ADVISE YOU TO USE AN ALTERNATIVE RELIABLE METHOD OF CONTRACEPTION.