Q: Do I really have to rest for 2 days, not exercise or do any heavy work for a week, rest my manual job for a week, not have sex for a week and be careful so my children will not to jump onto my scrotum for a while? All this advice seems a little excessive…
A: This advice is empirical. That means it has been assembled due to my and other surgeons experience. You may heal quicker and not need a recovery period of this length, but equally you may also heal slower and need even more time. Please be a patient patient. Dont rush and then regret.

Q: My plaster has come off early and there is a small opening visible.
A: This is not a problem, provided there is no other but clear discharge. The wound will heal from the back, although the process can sometimes take weeks. If you can see pink or white tissue on the bottom of the small opening this is usually a sign the wound will now soon be healed. Until then it is wise to keep the wound covered with a dry dressing and not to soak in (dirty) bath or pool water. Use the additional dressing provided in your aftercare pack if required. Should there be any pus like or turbid discharge or the wound appear increasingly red, please give us a ring or see your GP.

Q: Why do you not use glue or stitches for the wound closure?
A: Glue is a really problematic substance because its application is difficult. It must stay on the surface and not trickle in the wound otherwise patients can end up with wound granulomas and huge woundcare problems. Non absorbable sutures would have to be taken out and can cause infection, bleeding and inflammation. Absorbable sutures do not have to be taken out, but also can cause infection, bleeding and inflammation. The following method we developed ourselves and has resulted in minimal patient callbacks and maximum satisfaction:

1. Iodine on skin under plaster – this keeps the skin disinfected
2. Silicone plaster for a week – this keeps the wound protected to heal, the skin around is disinfected
3. Advise not to change dressing, take it off or tamper with it – this is to not bring bacteria into the disinfected area
4. Advise not to bathe – again, not stagnant water, no bacteria
5. Not to get the wound wet for 48 hours until the silicone plaster is properly bonded and there is initial healing to the wound.
6. Leave the 5mm wound open, but gently squeeze the edges together after surgery. The plaster will hold the edges, but if blood has to come out then better out than in (like a surgical drain which you can sometimes see with a bottle after abdominal surgery).
7. Add a second plaster to the aftercare pack if the original dressing comes off and advise the patient to apply it in a sterile fashion.

Q: Since I had my vasectomy there is some blood in my semen when I ejaculate.
A: Within 8 weeks of your vasectomy thats fine. The longer ago your vasectomy took place the more altered the blood should appear. Fresh blood 2-3 months after your vasectomy is not ok and you should see your GP. There can be many causes including acute prostatitis and more serious issues and it needs evaluating swiftly.

Q: I have done 30 ejaculations, but the 20 weeks have not passed yet, should I send my sample off, early?
A: Definitely not. Please wait until at least 20 weeks have passed before sending your sample. The chance of a negative sample is higher, the need for repeat samples is lower and also the chance of spontaneous recanalisations (late failure) after the sample has been done reduces further.

20

Q: 16 weeks have passed and I have not yet done 30 ejaculations. Should I send my sample off, anyway?
A: Definitely not. Please, ensure you have ejaculated at least 30 times before sending your sample.

Q: I had no pain in the first 2 days after the procedure, but now there is some aching. Is this normal.
A: Usually quite so. Initially you rest a lot. After you resume more activities you may get more tenderness. Take some simple analgesia i.e. Paracetamol or Ibuprofen (unless you are allergic or this medication is not recommended for you, if in doubt ask your pharmacist or GP).

Q: I had no pain in the first 2 days after the procedure, but now, on day 5, I have to take painkillers. Is this normal?
A: Yes. The combination of activity resumption and inflammation / healing of the body makes – in our experience – day 5 the highest day of callbacks to the office. Give it a rest, take some more painkillers and use your icebags again and you should soon get over it.

Q: It is 1/2/3 weeks since my vasectomy now and I am still getting pain, is this normal?
A: It depends. Some people get no pain whatsoever, but most patients will experience some pain following a vasectomy. This pain is mostly mild and will usually disappear within a week, but about 3% of patients experience discomfort for up to 3 weeks and about 1-2% of patients can experience (some) pain for significantly longer than 3 weeks. If you experience pain, which is improving or stagnating / improving very slowly, then it is usually fine. However, if pain worsens suddenly or severely you would be advised to call us or see your own doctor. If in doubt feel free to ring us at any time.(unless you are allergic or this medication is not recommended for you, if in doubt ask your pharmacist or GP).

Q: I can feel no pain whatsovere, will I still be sterile, did you do my vasectomy properly, is this normal?
A: Absolutely, 25% of patients have no pain whatsoever, 50% of patients have mild pain and overall 75% of patients recover within a week with no more than mild to moderate discomfort, 90% in 2 weeks and 97% in 3 weeks.

Q: There is some swelling above or around my testicles following the procedure, which is / is not painful.
A: Swelling above the testicles and around the tubes following a vasectomy is quite normal and well described in the literature. Swelling of the testicle iitself is possible, but less well researched. If a swelling appears to become worse or warm / red or there are swollen lymph nodes in your groin or you get a temperature with pain in a testicle following the procedure, please ring us. The signs above can sometimes be indicators for an infection. A cool swelling (normal skin temperature), that improves slowly over time should not raise too many concerns.

Q: I have got some bruising in my scrotum, which is / is not painful.
A: Mild bruising is quite normal, just like after a blood test. Should you develop a blood clot bigger than 2cm / 1 inch in diameter or even more severe bruising (which you can feel in your scrotum), please let us know.

Q: Could an improvement or worsening of my erections / ejaculations / sex life be related to my vasectomy?
A: Only in psychosexual terms, anatomically this is impossible. You may need to see a professional.

Q: Could my waterworks be affected by a vasectomy
A: Definitely not, anatomically impossible. You need to see your GP.

Q: Since my vasectomy a swelling in my scrotum has disappeared and / or there is quite a bit of watery discharge from the keyhole
A: Some men have got hydroceles in the scrotum, which are fluid filled cysts. I can sometimes tell you about these when I examine you, but they are often so soft, they go unrecognised. After a procedure there is a sudden gush of fluid from the wound, which is normal. Sometimes the discharge can go on for a little while and often this problem has been cured forever.

Q: I had a vasectomy, forgot to put in my semen sample and now my wife / partner is pregnant.
A: Put in your semen sample first. A vasectomy failure (spontaneous recanalisation) can occur in about 1 in 200 vasectomies.

Q: I had a vasectomy, was confirmed sterile and now my wife / partner is pregnant. She reassures me she has not had sex with anyone else.
A: Don’t immediately mistrust your partner. Submit a semen sample. Very very rarely (and I personally never had a case) patients can have a late failure (late spontaneous recanalisation).