Vasectomy – what to expect

Vasectomy – what to expect

To go ahead with a vasectomy you need to:

1. Book the date of the procedure by phone (tel. +48 607 776 777)
2. Fill in the health questionnaire

Contact with the doctor

1. A conversation and medical interview (a series of questions about your health, past illnesses and life situation)
2. A review and discussion of any medication you take.
3. A discussion of the effects and outcomes of the vasectomy.
4. A thorough examination of the genitals.

All this serves to assess the indications and any contraindications for the vasectomy.

Vasectomy – what to do in the days before the procedure:

1. Do not regularly take large doses of Aspirin, Polopiryna, Acard or other medicines containing acetylsalicylic acid (acidum acetylosalicilum) or salicylates for two weeks before the procedure; please discuss the use of other medicines with your doctor before the vasectomy.
2. Fill in the patient questionnaire
3. Shave the scrotum thoroughly – preferably 4-5 days before the procedure – so that the patient does not feel the unpleasant sting when the antiseptic is applied.
4. Plan your transport home after the vasectomy (preferably a taxi or a companion as the driver). You can drive yourself after the procedure. In that case, however, you should wait at least 45 minutes after the procedure before starting the car engine.
5. Take a shower and wash your whole body thoroughly twice with soap (preferably antibacterial), especially the genitals, immediately before leaving home for the vasectomy (including the glans under the foreskin).
6. Do not eat or drink anything for 3 hours before the procedure, and the meal should be easy to digest, i.e. without meat, vegetables or fruit. For example, scrambled eggs with butter, cheese, white bread.
7. Come for the vasectomy in comfortable loose trousers.

Vasectomy – what to expect after the procedure – recommendations:

• Sometimes (if the doctor recommends it) an ice pack wrapped in a towel is applied for about 1 hour.
• For the rest of the day after the vasectomy it is advisable to limit physical activity. Ideally you would lead an “armchair lifestyle”. Similarly, over the next 1-2 days activity should be increased gradually. Patients doing heavy physical work can be given sick leave.
• You can take a shower only the next day.
• For a week you should avoid heavy physical work and physical exercise.
• The site where the no-scalpel opening was made should be kept clean and dry, by changing the gauze once a day for three to five days – or as recommended by the doctor.
• A small amount of blood on the gauze is normal. A bruise on the skin of the scrotum and around the base of the penis is also normal.
• In case of excessive bleeding, severe swelling or pain, you must see a doctor.
• The doctor may prescribe antibiotics for a few days after the procedure.
• Before stopping the contraception you have used so far, you must obtain the desired semen analysis result.
• The semen analysis is best done 8-12 weeks after the procedure and after 30 ejaculations.
• For greater certainty it is worth repeating the semen analysis after another 2-4 months.

Vasectomy – what to expect after the procedure – returning to activity?

Most men feel well enough after a vasectomy to return to work the next day, or within a few days if they work physically. Sexual activity can be resumed after about 2-3 days, but very gently, slowly and in the so-called spoon position. At first, ejaculation may cause some discomfort in the groin and testicles until the tissues have fully healed. Some men may have trace amounts of blood in the semen.

You should avoid lifting very heavy objects or playing sport for 2-3 weeks, or expect discomfort or even pain.

Until the semen analysis shows that there are no sperm in the ejaculate, you must use another, additional method of contraception.

When to see a doctor immediately:

• If symptoms of infection appear, including fever and chills
• Redness, swelling, intense pain, excessive bleeding or a discharge of pus from the opening through which the procedure was performed

Possible complications:

Possible early complications after a vasectomy – our own statistics

• a bruise (discolouration) on the skin of the scrotum (in my practice about 20%)
• the presence of a small amount of blood in the ejaculate (in my practice about 3% – if ejaculation took place earlier than 7 days after the procedure),
• slight discomfort or soreness of the testicle, scrotum, groin or above the pubic symphysis, which usually disappears on its own after 2-4 days and does not require painkillers (in my practice about 30%)
• Soreness of the scrotum, testicle, groin or above the pubic symphysis requiring mild painkillers (e.g. ibuprofen), felt for several days or even weeks (in my practice about 3%),
• bleeding and a resulting haematoma in the scrotum is a complication seen in my practice in about 0.2% of cases – the haematoma may be absorbed within a few weeks or require surgical removal (most often it is absorbed spontaneously),
• inflammation and the development of infection at the site of the procedure – in my practice below 1%)
• infections (inflammation) of the testicle or epididymis (described in the literature) – in my practice 0% so far
• transient swelling at the vasectomy site – in my practice below 1%
• Complications related to the anaesthesia (allergy to the drug) – described in the literature (in my practice there has not been a single case so far)
• An ineffective vasectomy, or early recanalisation = the presence of live sperm 3 months after the procedure. In my practice 0.1%.
• Pregnancy after a vasectomy – 1 reported case (not confirmed by genetic paternity testing or by establishing the time of conception).

Possible late complications after a vasectomy

• Chronic pain around the testicles – the so-called Post-Vasectomy Pain Syndrome – very rare with the “Canadian” method (described in the literature – in my practice there has not been a single case so far). Chronic testicular pain is described very often in men who have never had any procedure within the scrotum. It is most often linked to mechanical injuries sustained in the past, e.g. as a result of intensive regular cycling training.
• Late recanalisation – (described in the literature – in my practice there has not been a single case so far).
• Sperm granuloma. This is a vascularised lump, palpable with the fingers and visible on ultrasound; it requires excision because it cannot be distinguished from a tumour. In my practice there has been one case so far.
• Swelling and testicular pain occurring within a year after the vasectomy – very rare. Described in the literature – in my practice there has not been a single case so far.
• A drop in libido and psychological problems related to the loss of fertility. Described in the literature – in my practice there has not been a single case so far.
• The formation of anti-sperm antibodies in the body in response to the secondary resorption of sperm – these may be a problem when trying to conceive again after a successful vasectomy reversal.

What increases the risk of complications during a vasectomy

• Local infection
• Blood clotting disorders (e.g. congenital or related to the use of aspirin and similar medicines)