Typically there is mild discomfort for 5 – 10 days. It’s usually in the scrotum, but it may radiate to the groin or even the lower abdomen (like a menstrual cramp!) It can be one-sided or bilateral. Swelling is usually mild. It is often most noticeable on the third or fourth day. That’s why you need to follow these 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. Do as little walking as possible for a whole week. No sports! No yardwork! 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). Lift nothing over 15lbs for the first two days, and nothing over 50lbs for the first week. If in doubt, don’t do it! You can increase your activity gradually day by day, but remember to always err on the side of caution.
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 with a little water in a freezer bag is undoubtedly the cheapest and probably the best. It will take a while for the cold to penetrate the gauze and jock strap, but you’ve got lots of time.
Wound care: There may be a drop or two of blood on the gauze in the first two days, but no continued bleeding or seepage after that. Have a peek every once in a while to make sure all is well.
The jock strap is just to keep the scrotum still and elevated for the first week. Take the strap off when you have a shower. You only need the gauze against the skin for the first two days. You may want to wear the jock on the outside of your underwear to avoid the rough cloth on tender skin. The support 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. It’s not a good idea to drink with naproxen in your system anyways. Not only should you not drink, you should also stay away from drunks.
Pain and its management: We provide you with acetaminophen (Tylenol) for the first two days, then enteric coated naproxen 500mg twice a day for the next five days. The naproxen is not just for pain. It also reduces inflammation, which often peaks around day three or four after vasectomy. People who get stomach upset from naproxen can substitute another anti-inflammatory like Celebrex. Those allergic to naproxen or aspirin can substitute acetaminophen. Remember, swelling is what this part of the anatomy prides itself on doing best, so take the naproxen for the full five days whether you think you need it or not.
Sexual activity: No ejaculation for a week. If you don’t follow this one you void the warranty. (Just kidding, there is no warranty.) After 7 days you get to resume sex, but still use birth control precautions until the sperm counts show you are clear.
Fever, severe pain or swelling over pea sized? These are not usual. Call me if this happens. (You will get my cell phone number at surgery.) 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.
Follow-up visit: I’d like to see you back for a brief follow-up in 5 to 14 days. I check on healing, and review your next assignment… semen testing in 12 weeks. Don’t forget the backup birth control until we’ve done the tests to ensure the vasectomy worked. (The proof is in the pudding!)
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.