Information/Instructions for No-Scalpel Vasectomy

Instructions for Vasectomy

1. You have been booked for bilateral vasectomy to be done in my office under local anesthetic. Phone us 2 to 3 days before your appointment to confirm that you will be coming for the procedure. We reserve the right to bill patients who do not show up for their appointments.

2. Have somebody bring you to my office and pick you up after the procedure. You should not drive for 24 hours. You will be here for about 1 hour. The procedure itself takes about 10 – 15 minutes.

3. You should shave the scrotum in the front at the junction of the penis and scrotum completely and trim the pubic hair the day before the procedure.

4. Bring an athletic supporter with you. Have a shower on the day of the procedure and wear clean underwear, socks and clothing.

5. Please take 2 tablets of Tylenol #3 with water and Ativan 2 mg sublingually (under your tongue) one hour before you come to my office for the procedure.


Information About Bilateral No-Scalpel Vasectomy

Vasectomy is an increasingly popular, simple method of sterilization. Complications are minimal. Studies comparing various methods of birth control show that couples relying on vasectomy, on the average, have sexual intercourse more frequently and find greater fulfillment and satisfaction in their sexual relations than couples using other methods of contraception.

Informed consent is essential. You should know that this is a permanent, irreversible procedure. Reversal procedures are being done, but they are expensive and the results are unpredictable. Therefore, vasectomy should not be used as a temporary contraception. You should remember that you are not considered sterile until a sperm count establishes that fact. At least two sperm counts, 2 months and 3 months after vasectomy should be obtained. Other methods of contraception should be used until a sperm count demonstrates sterility. Recanalization and failure of vasectomy occurs in about 1% of patients, usually within two months of the operation. There are reports of late failures as well. You will get an appointment to see me 2 months after vasectomy when instructions will be given to you regarding the sperm counts. Current evidence does not show that vasectomy would adversely affect your health in anyway.

Are there any complications after vasectomy?

Complications after vasectomy are rare – but there is no guarantee that nothing will go wrong. About 95 – 99% of the patients do very well with no complaints. A small percentage of patients do get complications like: bleeding, infection, swelling and pain. Pain usually starts after 3 to 5 days. If this occurs, then get in a hot bath 2 to 3 times a day and take Tylenol #3. If the pain does not get better within 24 -48 hours then see your doctor or come back and see me. Usual healing process takes about a week. So use common sense and be careful. If there are no complications then you should feel no pain.

Post-vasectomy pain syndrome: Sometimes patients have complained of pain in the testicular area long after the vasectomy. In some cases, the pain corresponds with ejaculation. This symptom is rare. The exact mechanism underlying this pain is not known, but it could be related to the active transport of sperms from the testicles to the surgically divided vas. Occasionally, you may get a swelling where the vasectomy is done and this is called sperm granuloma. Sometimes, this area gives pain and discomfort and this can be excised if it is a source of discomfort and concern.

Post-Vasectomy Instructions

1. Do not drive for 24 hours. You are legally impaired after taking Tylenol #3 and Ativan.

2. Rest at home until the day after surgery. Put ice-pack on the scrotal area as often as possible on the day of surgery. You may resume your normal activities after one or two days. But avoid work and strenuous exercise for at least 48 hours. This will help the wound heal.

3. You may shower day after surgery. You can get the incision wet, but do not rub anything in that area for 48 hours. Dab it dry. Apply polysporin and gauze for three days. The scrotal incision has no stitiches and takes about 3 days to heal. Sometimes pain starts after 3 days, then sit in hot bath 3 – 4 times a day and take Tylenol #3. If it is no better than see me or your family doctor.

4. Do not pull or scratch the wound while it is healing.

5. Wear a snug undergarment or scrotal support for at least one week after surgery. This will help you to be comfortable.

6. You may have sex with your partner as soon as it is comfortable for you. This is usually two or three days after the operation. Remember, vasectomy does not work immediately, and you can still get your partner pregnant. Sperms should be gone after 20 ejaculations. Use condoms, or ask
your partner to use another family planning method until you have two negative sperm counts – one after two months and second after three months. If there are no sperms then we will let you know that you are sterile.

7. You may have a little pain, bruising, or swelling where the wound is. Watch it to be sure that it does not get worse. A small amount of pain, bruising, or swelling that does not get worse is normal. Take the medication recommended. Be sure to follow the instructions given to you. An ice pack may help relieve the pain, bruising, or swelling. Hot bath also helps.

8. Call me:
-If you have fever within one week of surgery
-If there is any bleeding or pus in the wound
-If there is pain or swelling around the wound that gets worse or does not go away
-If your partner ever misses a period or thinks she is pregnant. This is very important. It may mean the operation has failed, and your partner may be pregnant.

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Some Answers to Questions About Flexible Sigmoidoscopy


This test has been booked for at to be done in my office.
If you fail to keep this appointment, then we reserve the right to bill you for not showing up.

How to prepare for Flexible Sigmoidoscopy?
1. Stay on clear fluids after lunch the day before the procedure.

2. The evening before the test, take one bottle of Magnesium Citrate at 8:00p.m. One or two hours before coming to my office, use one FLEET ENEMA rectally.

3. No Aspirin or Aspirin containing pills for 7 days and no blood thinners like Coumadin for 3 days before the procedure. Consult your family doctor.

4. Stay on clear fluids the day of the procedure.

5. Take Midazolam 7.5 mg orally with water ½ hour before the procedure. You cannot drive that day.

What is Flexible Sigmoidoscopy?

A Flexible Sigmoidoscope is a short flexible tube that is about the thickness of a finger. It is inserted through the rectum into the large intestine (colon) and allows the physician to carefully examine the lining of the left colon. Abnormalities which are too small to be seen on x-ray may also be identified.

If the doctor sees a suspicious area, he can pass an instrument through the scope and take a small piece of tissue (a biopsy) for examination in the laboratory.

What is Polypectomy?

During the course of the examination, a polyp may be found. Polyps are abnormal growths of tissue which vary in size from a tiny dot to several inches. Polyps are usually removed because they can cause rectal bleeding or contain cancer. Although majority of polyps are benign (noncancerous), a small percentage may contain an area of cancer in them or may develop into cancer. Removal of colon polyps, therefore, is an important means of prevention and cure of colon cancer, which is a leading form of cancer in Canada.

What should you expect during the procedure?

Usually, no medication is required for this procedure. While you are lying in a comfortable position, the scope is inserted into the rectum and gradually advanced through the colon while the lining is examined thoroughly. The scope is then slowly withdrawn while the intestine is again carefully examined.

The procedure is usually well tolerated and rarely causes pain. There may be some discomfort during the test but it is usually mild. A limited examination may be sufficient if the area of suspected abnormality was well visualized. Rarely, the examination may be unsuccessful due to technical reasons.

What happens after flexible sigmoidoscopy?

You may feel bloated for a few minutes right after the procedure because of the air that was introduced while examining the colon. You will be able to resume your diet after the test unless you are instructed otherwise.

Are there any complications from flexible sigmoidoscopy and polypectomy?

Flexible sigmoidoscopy and polypectomy are safe and are associated with very low risk when performed by physicians who have been specially trained and are experienced in these endoscopic procedures. One possible complication is perforation in which a tear through the wall of the bowel may allow leakage of intestinal fluids. This complication usually requires surgery, but may be managed with antibiotics and intravenous fluids in selected cases.

Bleeding may occur from the site of the biopsy or polyp removal. It is usually minor and stops on its own or can be controlled by cauterization (application of electrical current) through the scope. Rarely, transfusions or surgery may be required.

Why is Flexible Sigmoidoscopy necessary?

Flexible sigmoidoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by x-ray can be confirmed and studied in detail. Even when x-rays are negative, the cause of symptoms such as rectal bleeding or change in bowel habits may be found. It is useful for the diagnosis and follow-up of patients with inflammatory bowel disease as well.

The greatest impact is probably in its contribution to the control of colon cancer by polyp removal. Before, major abdominal surgery was the only way to remove colon polyps to determine if they were benign or malignant. Now, most polyps can be removed easily and safely without surgery.

Periodic scoping is a valuable tool for follow-up of patients with previous polyps, colon cancer, or a family history of colon cancer.

Flexible sigmoidoscopy is a safe and extremely worthwhile procedure which is very well tolerated. If you have any questions about your need for this test, do not hesitate to speak to me, and I will be happy to discuss it with you. We share a common goal – your good health – and it can only be achieved through mutual trust, respect and understanding.

Additional Instructions: If due to unavoidable circumstances, you cannot keep your appointment, please let us know well in advance for us to call another patient waiting for this test.

Revised: July 7, 2003

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