Day of Procedure
Spend the day and evening at home. Relax and recline in a bed or reclining chair. Minimize activity. Many men read a good book, or watch a Netflix series. It’s OK to do laptop computer work with a pillow on your lap.
Most men feel like they’ve received a “kick in the nuts,” but not a huge kick. Many men say it feels like they’ve been kicked by a four-year-old. This feeling of being kicked lasts about two or three days, and comes and goes over the next week when you’re moving around. After a week or two, this feeling fades, though in a few men the soreness can last awhile longer. How men feel after a vasectomy is highly variable – some men have only a few days of soreness, some men have a few months. This is just like any other minor surgery.
It’s OK to take acetaminophen (Tylenol or generic). The typical dose is 1,000mg (2 tablets of 500mg) every six hours if you have discomfort. Limit your total daily dose of acetaminophen to 8 tablets (4,000mg) or less per day. In general, don’t take acetaminophen for more than a few days.
There is no need for ice packs or frozen peas, though some men find them comforting. You choose.
The Next Day
You may walk and drive as much as you like. Most men go for a gentle walk around the neighborhood or in a peaceful park. It’s OK to do office work. Don’t jump right back into sports, yard work, swimming, or heavy lifting.
You may take a shower starting the morning after the procedure. After your shower, put the snug underwear back on. Wear nice snug underwear for the next two days, and for the next seven days during sports. Many men find they are sore if they flop around wearing loose boxers, so do give yourself good support.
Two Days after the Vasectomy
You may return to more strenuous work and regular activities two days after the procedure. Wear your snug underwear. Wait three to four days for more vigorous sports like basketball or tennis. Wait about seven days before riding a bicycle.
You may start having sex two days after the procedure. Expect to be a little sore the first time. It’s also common to have some blood in the semen during the first ejaculation. Sometimes the blood can occur even a month after the procedure – it’s no cause for concern.
Make sure you use some form of contraception. A vasectomy is a great method of contraception, but you shouldn’t rely on it until after you receive the results of your semen test (more about this below).
As with any small surgery, it is normal to have some bruising. Many men have a little bruise the size of a quarter or less, though some men have a larger bruise. Some men have bruising the next day, others have bruising after a few days.
The Next Week
Gradually increase activities. Most men will be sore at first when they start running again or working out. This is normal and will slowly resolve. Wearing the scrotal supporter or snug underwear helps keep you from bouncing around and helps with the soreness.
There is no need for a follow-up appointment. No incision was made, so there are no stitches to remove.
During the week after your vasectomy, you may get some delayed bruising. Blood from inside the scrotum can come to the surface and discolor the skin. This purplish-blue mark can spread and get darker, then gradually dissipates.
Many men also get some swelling. The swelling can come in several forms. It is very common to have some generalized swelling in the scrotum that appears on day one or two and then slowly resolves. Many men also develop swelling above one testis that feels like a small sausage in the scrotum. This swelling is caused by blood leaking into the sheath around the vas. This blood will be reabsorbed by the body over the next few weeks. Another common form of swelling occurs just above or around the testis. This can occur anywhere from 3 days to 3 months after the vasectomy. This swelling feels like a crescent on the back of the testis or a small ball just above the testis. This is a normal response to the surgery, and is thought to be caused by the early scar formation in some cases, and the normal reabsorption and recycling of sperm on other cases. Either way, this is best managed by taking ibuprofen 600mg (three tablets of 200mg), three times per day with food and water. Take the ibuprofen until the tenderness subsides, then add a day. In general, though, don’t take ibuprofen at this high dose for more than seven days.
Usually during the weeks after a vasectomy, the soreness fades. Some men don’t feel any soreness after the first few days, and some men have soreness that lasts for a couple of months. The average man is sore for a week or so. Every man is a little different. Like with any other minor surgery, the soreness usually gets better slowly and eventually just goes away.
Many men have questions about specific sports. In general, the idea is to lay around and not do much right after your vasectomy. It’s OK to walk around the house, but in general take it easy in your bed, sofa, or recliner. The day after your vasectomy, it’s OK to take gentle walks and drive around. The next day after that, it’s OK to start back to the gym, sex, work, etc, just take it easy. Wait three or four days for vigorous sports like basketball or tennis. Wait about a week before you really squash your scrotum around – for example with bicycles, motorcycles, unicycles, mechanical bulls, horses, bucking rodeo animals, etc. The traditional wisdom is to not go swimming or soak in a hot tub until a week has passed after a minor surgery.
Twelve Weeks Later….
Wait twelve weeks or later, and then mail a sample to the lab. While you are waiting the twelve weeks, have plenty of ejaculations to “clear out the tubes.” Twenty ejaculations or more is a good number, but this doesn’t have to be exact.
Many patients ask us if it’s OK to send in a sample before twelve weeks if they have already had the twenty ejaculations. Don’t mail the sample before twelve weeks. When patients mail in the sample too early, they are often surprised that there are still a few leftover sperm in the sample. Really do follow the instructions and wait the twelve weeks. The goal is to test whether there are any sperm after all the healing has taken place.
Mailing the sample
Click on the link below to access the lab, PVSA.org. Please read the instructions carefully, and fill out the online form. After completing your own information, scroll down the form and fill in the date of your procedure. The date does not have to be exact, but it helps to be in the right ballpark. The lab will send you a small box with the container, the preservative, and a pre-paid mailer. Once the kit from PVSA.org arrives, make the sample at home, use their container and mailer, and await the results. We have chosen to use PVSA.org because they specialize in analyzing semen after a vasectomy. They use lab technicians who literally focus on semen. They are experts. The cost is $50 for one mailer or $90 for two. The US standard is to use one test at 12 weeks, but some men feel more confident with two. You decide. Here is the link to PVSA.org.
Finally…
Thank you for placing your confidence in us. Vasectomy is one of the most effective forms of contraception. The modern procedure is gentle, reliable, and doesn’t affect testosterone or sexual performance. In our practice, even the physician has had his own vasectomy and has been enjoying it for years. Welcome to the club!
