Instructions for after your vasectomy

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 scrotal supporter back on, or replace it with snug underwear. Wear the supporter or snug underwear for the next two days, and for the next seven days during sports.

Two Days after the Vasectomy

You may return to more strenuous work and regular activities two days after the procedure. Wear your scrotal supporter or 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.

Twelve Weeks Later….

Wait twelve weeks or later, and then either mail or bring in a semen sample. The bag you were given has instructions and includes either a mailing kit or container. 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 or bring in the sample before twelve weeks. The goal is to test whether there are any sperm after all the healing has taken place. If we have your sample before twelve weeks, we just have to throw it away – we can’t process it.

Bringing in the sample

If you are bringing in the semen sample, it should be in a small container with a lid, for example a pill bottle, baby food jar, vitamin bottle, etc. Please don’t bring in a condom or plastic bag since we won’t be able to retrieve an adequate specimen from these types of soft containers. You will be asked to return later with another sample in an appropriate container. The sample should be produced on the day you bring it to the lab, but can be up to four hours old. Also, please remember that the Lutz office is the only office that can process the sample. If you bring the sample into any of the other offices, they will not be able to process the sample and they will ask you to mail the sample to us at the Lutz office. The hours of the Lutz office for lab samples are Monday, Tuesday, Thursday, and Friday from 9am to 4pm. Please note the Lutz office is closed on Wednesdays. Also, it’s a good idea to call before bringing in the sample. Our office is usually open during the regular hours listed above, but occasionally the staff takes a well-deserved vacation. During the few weeks every year that the staff is away, the office is closed. Call 813-536-1429 to verify that the office is open. It’s rare that this happens, but it’s a bummer to be standing outside the closed office with that sample in your hand. Calling in advance can save you time and gas.

Mailing the sample

Please use the test tube, plastic bag, and little cardboard box you were provided. Please read the instructions. You don’t have to use ice or any special high-speed courier. Regular postal service will do. There is a trace of a special preservative in the test tube that will preserve the sample. Make sure you include your name on the lab slip you were given. If the sample doesn’t have your name, we can’t process the sample. After you mail the sample, wait 5 to 7 business days and call 813-536-1429 for the results.

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.  I had mine over twenty years ago, and have been very happy with the results. Welcome to the club!

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