Most casual observers will think of the North Star as the brightest star, in fact it is Sirius. (The North Star is known for its dependable location in the sky, not its brightness.)
According to Greek mythology, Sirius was the dog of the hunter Orion, and the ancient Romans placed the star in the constellation Canis Major (Latin for “Greater Dog”). The Romans thus referred to the sweltering period when the rising of the sun and Sirius converged as the “dies caniculares” or “days of the dog star.”
By the 1500s, the English world began to call the same summertime point on the astronomical calendar as the “dog days.”
You have had your vasectomy…here are some “after the procedure” instructions and a heads up on potential issues that are peculiar to having a vasectomy.
The small opening at the midline of the upper strotum does not have a suture and will close on its own. A thin film of Neosporin ointment daily is recommended.
You can shower the day after the procedure, but don’t let water hit the procedure site directly.
Ice to the scrotum after the procedure helps with swelling and with discomfort. (Lidocaine is used at the opening and along the course of the vas tubes so there is anesthesia for an hour or so after the procedure.)
You’ll be given something for pain, this is to be used in an “as needed fashion.” If you don’t have pain, don’t take it or use Advil or Aleve. Taking a half a pill is acceptable.
Try to be off your feet with the scrotum elevated strictly for the first 24 hours and then as much as possible for the next two days. Most patient who have the procedure on a Thursday or Friday take it easy over the weekend and return to work on Monday. If you have a strenuous job, you may want to gradually get back into your routine.
For the first week after the vasectomy, compression underwear to stabilize the scrotum and elevation of the scrotum with a rolled sheet when sitting can reduce any swelling.
No sexual activity for one week.
No unprotected sexual activity until we have evaluated two negative specimens. It takes approximately 25 ejaculations to clear the tube beyond the vasectomy site. (A couple can achieve pregnancy if there is unprotected sexual activity before the sperm has completely cleared.) We recommend evaluation of specimens as a rule at 6-8 weeks. It is not about the time since the vasectomy, it is about the number of ejaculations.
Even though the opening is in the middle of the upper scrotum, the vasectomy sites are on the left and right underneath the skin. Discomfort, bruising or asymmetrical swelling is not uncommon, but should slowly improve over several days.
Each patient is given two specimen containers after the procedure and there are several options regarding checking the post-vasectomy specimen. Dr. McHugh examines semen specimens with a microscope at no expense. (The best days for dropping off the specimen is Monday, Wednesday and Friday-but it best to call to be sure he is available to examine.) For out of town patients, specimens can be taken to a local hospital for a “post vasectomy” semen analysis (we can fax an order) or use online test kits such as spermcheck.com.
It is not unusual, maybe 5-10% of specimens, will have a rare sperm. This just means that more time/ejaculations are necessary to completely clear all of the sperm. We will require two consecutive completely negative evaluations.
There are no special instructions about the specimen. If you obtain the specimen in the morning and drop off later in the day, this is not a problem. We are not doing a formal count, only the presence of absence of sperm. We will call you back with the results that day.
If any issues arise that you have questions about, feel free to contact us using the form below. We will be happy to speak to you or if you feel necessary examine you in the office at no expense to you.
You also can utilize our text to email option. (You text your comment/concern and it comes immediately to our email. We check our email numerous times a day and on weekends.) The response comes back to you as a text. Here’s the number: 770-376-5616
Thank you for allowing us to participate in your care.
Bullet points/instructions for the post vasectomy reversal operative period:
You can shower but for the first two to three days, don’t let water hit the operative site directly.
A thin layer of Neosporin over the suture sites daily is recommended.
A formal dressing is not required but one 4×4 gauze between underwear and the sutures may be more comfortable.
The sutures dissolve-but not all at the same time. Some separation of the skin in areas is not uncommon and resolves.
The feeling of a “lump” under the skin above either testicle is not uncommon, this is where the body is reacting to the surgical procedure. (It is not uncommon to have this on one side but not the other.)
Compression underwear for three weeks. (This is preferred to the traditional “jock strap.”
No sexual activity for three weeks. Slowly returning to your normal exercise at that time can resume as well.
The more you can be off your feet the first week following the procedure the less swelling you will have. Some bruising of the skin around the suture sites is common.
Patients can walk and even drive if necessary after 5 days if wearing compression underwear and being careful. Again, the more you are off your feet the better.
The testicles begin producing normal sperm again in 4-6 months, depending on the length of time from the vasectomy. (The longer the interval from the vasectomy, the slower return to sperm production.)
If you desire to have an evaluation of a semen specimen to check for the presence of sperm, one would wait until the 4-6 month period after the reversal. The presence of sperm is a very good sign, however it is not unusual for a longer interval is required for the return of sperm. A specimen can be given to our office and can be quickly evaluated for the presence of sperm. If a formal semen analysis is desired which provides an actual count of sperm, an order can be placed to your local hospital negating having to travel to Gainesville.
If pregnancy occurs, it is usually in the 6-18 month time frame.
If pregnancy occurs…we’d appreciate a picture.
Finally…we appreciate the opportunity to participate in your care.
Georgia’s most experienced No Scalpel Vasectomy and Microscopic Vasectomy Reversal urologist.