The Medical Procedures Center, P.C.

"We treat people, not just problems."

John L. Pfenninger, M.D.

Lori Oswald, P.A.-C.

4800 N. Saginaw Road, Midland, MI 48640

(989) 631-4545

Visit our Website at http://www.MPCenter.net

POST OPERATIVE VASECTOMY INSTRUCTIONS

NOW THAT YOU'VE HAD YOUR VASECTOMY

There are a few routines and instructions we would like to pass along to assure the greatest degree of comfort possible after your vasectomy. The counseling session you had provided an opportunity to ask any and all questions and to prepare you. To remind you of suggestions given on the videotape and during the private interview, keep this instruction sheet handy. Please feel free to call if you have any further questions.

Activity

Day 1 —	This is the day of surgery. Wear a jock strap. Use gauze or a wash cloth inside the supporter to keep pressure on the area. When you go to the bathroom, put some antibiotic ointment over the incision. Do this for 2-3 days. Put your feet up in an easy chair with an ice bag on your groin to reduce the swelling and bleeding. You can put the ice over the supporter under your pants. Use ice as much as possible until you go to bed. Get up only to go to the bathroom and to eat. Take the ibuprofen, three (3) tablets 4x/day (2400 mg). If there is still pain, it's okay to add on Tylenol but not aspirin.
Day 2 —	Cool shower, walk around; no heavy lifting or vigorous physical exercise. If swelling increases, sit down and relax as you did the first day. Wear a supporter but you don't need ice, the gauze, or the wash cloth (see below). Take the ibuprofen (3 tablets 4x/day).
Day 3 —	Increase activity but limit maximum still. It's OK to go to church, golf with a golf cart, etc… Continue wearing athletic supporter for comfort, if needed. Use ibuprofen up to 2400 mg per day for any pain.
Day 4 —	Return to normal activity and work. Limit jogging and pumping weights for at least one week.

Pain

Take (3) 200 mg ibuprofen four times per day (maximum of 2400 mg or 12 of the 200 mg tablets per day) for the first two days whether you need it or not If you feel you need something more, take 2 or 3 Tylenol up to 4 times per day, 2 hrs. after each dose of ibuprofen. After two days, use it only as needed.

Bandage

Day 1 —	When you leave the office, you will be wearing an athletic supporter filled with gauze. This is fine for day 1. When you go to the bathroom, replace the gauze or use a washcloth to keep pressure on the scrotum. This reduces swelling and bleeding. Use an antibiotic ointment over the wound for the first 2-3 days.
Day 2 —	Athletic supporter.
Day 3 —	Athletic supporter until comfortable without it.

Sexual activity

1st Week —	Once* after 1 week, if comfortable
2nd Week —	2 times*
3rd Week —	As desired*

*Maximum, with another form of contraception utilized until semen checks are negative.

Possible reactions

Infections -	are rare, but call if excessive redness, swelling, tenderness, fever, or oozing of pus from incision occurs. This usually will occur after the second day but infections have been identified up to 6 weeks after surgery. It's OK to put antibiotic ointment on the surgery site if you want.
Bruising -	over the scrotum is normal for up to about 2 weeks. You may get a "purple penis".
Swelling -	a small amount is not uncommon. Anything more should be reported. You will feel a small "lump" inside where the surgery was done for a few weeks. It will go away.
Granuloma -	some men get another type of nodule where the vas was cut. Usually this is not painful and will go away. If it is larger than 1/2 inch, call me and we will begin medication to shrink it. This can start a few months or even years after a vasectomy. (Remember, a small lump can usually be felt for up to three months in most cases.)
Failure -	is always a possibility. Use contraception until you have two semen checks without sperm in them.
Bloody Ejaculate -	rare but possible for up to six months.
Pain -	like an old fracture, a few men can have a long-term ache in the scrotum (or even in the groin) where the surgery was done. Rarely is any treatment even needed.
Long Term -	No long term side effects like prostate cancer, high blood pressure, etc. have been proven with vasectomy.

SEMEN CHECKS

We will do two semen checks to confirm sterilization. Although no appointment is needed, be sure that the office is open. The first will be done at 6 weeks or after 15 ejaculations (whichever is later). The second will be done at 3 months. There is no extra charge for this. Bring a semen sample in a clean jar or the container provided within an hour or two after ejaculation. If ever you are concerned or want reassurance of sterilization, we will examine your semen for one year, at no charge. Be sure your name is on the container. Please use the OSHA approved medical hazard Ziploc bags.

ANOTHER FORM OF CONTRACEPTION SHOULD BE USED UNTIL YOUR SECOND SEMEN SAMPLE IS CLEAR OF SPERM. YOU ARE NOT STERILE UNTIL IT HAS BEEN DOCUMENTED THAT YOU HAVE HAD TWO NEGATIVE SAMPLES.