Common complaints;
soreness ,bruising, swelling & bleeding
Rare complaints; pus, fever , wound redness
Make sure to ask about: What is the patient’s name? How can we contact the patient? (e.g. cell phone number) When was procedure? Which office? Who was the vasectomist?
Pain by phone
Some soreness after vasectomy is common, and will most likely resolve on its own. When assessing for more serious pain, take a good history. Important information when asking about pain: onset, e.g. a few hours after vasectomy?, a few days?, etc. location, e.g. superficial on skin?, deep in groin? duration, e.g. how long does it last? a few seconds?, minutes? Hours? exacerbating factors, e.g. movement character, e.g. aching, sharp, burning, etc? associated features, e.g. pus, redness, swelling radiation, e.g. radiates up groin? No radiation, just local on scrotum? treatments they have tried, e.g. motrin, jockstrap, rest, ice, other?
After a good history, assess. Most tenderness is normal occasionally it means hematoma infection ,granuloma.
Treatment of Routine Post-Op Pain
Routine post-op pain usually responds to rest,ice, good support with tight boxer/jockstrap or ibuprofen
phone treatment of post-op pain:
ice pack for 5 to 15 minutes per hour for the first 48 hours after onset of symptoms,warm baths for 15-30 minutes after first 48 hours good support for scrotum, i.e. jockstrap or snug briefs, minimize walking, minimize prolonged standing,wear good support (jock or snug briefs) when walking, NSAIDs e.g. Ibuprofen 600 mg p.o. with food tid x10 days , paracetamol can be used also e.g. acetaminophen 500 mg p.o, 1-2 tabs q 4-6 hrs prn x 10 days not to exceed 8 tabs (4 grams) /24 hours, no sexual activities for 7 to 10 days patient to call clinic in am for evaluation.
patient to call back 2-4 hours if symptoms worsen or no improvement contact vasectomist who performed procedure (see phone list), contact Director of Vasectomy Services if vasectomy provider doesn’t respond, contact Medical Director if Director of Vasectomy Services doesn’t respond.
If any doubts, have patient come in for exam
Bruising by phone Ask about pain history as above, ask about extent of bruising. It is within the normal range to bruise scrotum, base of penis, upper thighs or lower abdomen.
Treatment of Post-Op Bruising.
Usually all patient needs is reassurance a jockstrap to prevent further bruising, patience to let bruise reabsorb,
patient to call back 2-4 hours if symptoms worsen, contact vasectomy provider who performed procedure,contact Director of Vasectomy Services if vasectomy provider doesn’t respond,contact Medical Director if Director of Vasectomy Services doesn’t respond,
if any doubts, have patient come in for exam
Swelling by phone A little swelling is normal, blood can ooze into the scrotum, vas sheath and groin (inguinal canal) .swelling is usually much worse with poor support (no jock strap) and physical activity (small vessels may open)
Treatment of Post-Op swelling
Usually all he needs is reassurance, compression (jockstrap) and rest (prevents further oozing) .Patient to call back 2-4 hours if symptoms worsen. contact vasectomy provider who performed procedure,contact Director of Vasectomy Services if vasectomy provider doesn’t respond,contact Medical Director if Director of Vasectomy Services doesn’t respond
if any doubts, have patient come in for exam
Weeks to months after vasectomy, a small swelling is common. This is usually a small scar (granuloma) on the vas tube. This can be slightly achy, but usually not painful. This is normal and will resolve slowly. The small scar usually gets better on its own. NSAIDs can help for comfort.
When in doubt, invite in for exam.
Bleeding by phone A few drops of blood on gauze or jockstrap on first day is normal Occasionally, incision will ooze a bit more.
Treatment of Post-Op Bleeding Advise compression. If pinching incision with fingers doesn’t stop bleeding, have them come in or consider ER (This is very rare!) patient to call back in 30 minutes or 1 hour. If bleeding doesn’t stop contact vasectomy provider who performed procedure,contact Director of Vasectomy Services if vasectomist doesn’t respond ,contact Medical Director if Director of Vasectomy Services doesn’t respond
if any doubts, have patient come in for exam
Rare complaints
If patient has pus, fever discharge, redness of the wound,
have them come right in for evaluation. contact vasectomy provider that performed procedure,contact Director of Vasectomy Services if vasectomist doesn’t respond,contact Medical Director if Director of Vasectomy Services doesn’t respond,
if any doubts, have patient come in for exam
In the rare case of no access to clinic, consider ER (this is very rare!)