Advise the patient on routine wound care instructions:
Call for fever, significant bleeding, drainage of pus, excessive scrotal swelling or pain.
Mild pain and swelling will resolve within seven days.
Acetaminophen or a NSAID may be used as needed.
Post-procedure instructions specific to vasectomy:
Apply an ice pack to the scrotum for 20-30 minutes at a time every few hours for the first 24 hours after surgery to reduce swelling.
Continue to use the athletic support strap, or tight-fitting underwear, for the next 24-48 hours, or longer if the patient desires.
Rest with legs elevated as much as possible for the first 24 hours after surgery.
No strenuous activity or lifting more than ten pounds for the first five to seven days.
No sexual activity for the first five to seven days.
Remain off work for the rest of the day of the procedure and the next day.
Scrotal hematoma is more likely to occur if these instructions are not followed.
Discuss confirmation of sterility:
The patient is not immediately sterile after the procedure! It is essential to remind him of this!
Advise the use of alternate methods of birth control until two semen samples are negative.
Provide the patient with two specimen bottles for semen samples.
Collect samples as indicated below.
Sample #1: Six weeks AND 15 ejaculations after the procedure.
Sample #2: Twelve weeks after the procedure.
Bring samples to the lab in the office within two hours of collection.
A post-procedure instruction sheet should be given to the patient (.doc).