Looking after yourself after vasectomy

How much time do I take off work?

We have had reports of men going out for a long lunch and returning to the office wearing the jockstrap and frozen peas under the desk! Most men usually take 1-2 days off work. The majority of vasectomies are done on a Thursday or a Friday to fit into people's schedules better. Most men take a couple of days off, but it does depend on what type of work you do. If it's a desk job going back to work early is possible, but if your job involves physical movement take your doctors advice. Online survey

What's the best way to look after myself after the procedure?

Take things easy for a day or so, and wear a supportive jockstrap as much as possible. Also Ice (especially in the first 24 hours) alleviates swelling to a great extent. One reader suggested wearing tight briefs/jockstrap and a pair of boxers to hold the frozen peas in place worked really well. Frozen corn has also been highly recommended. Advice from the newsgroup

What medicines can I take afterwards?

Take your doctor's advice on this, but generally most men take paracetamal based home remedies for a couple of days (if necessary). Aspirin based medications should not be used as they encourage bleeding. You should of course take your doctor or pharmacists advice.

How soon after the procedure can I have sex?

The answer to this one seems to vary from doctor to doctor - basically you need to ask your doctor this question! If you are told to wait a long time (several weeks) it might be an idea to ask him to explain why. Our on-line survey results indicate that most us check to see if things still work sometime in the first week after the procedure. Online survey result

How long will the bruising and swelling last?

Some men report little or no swelling and bruising, but for most the bruising gets worse for a few days and disappears by the end of the second week, and the swelling goes down after a few days. Online survey

How quickly does it become effective?

Vasectomy is not effective until the system is cleared of sperm, this is usually 2-3 months, maybe longer. Believe it or not, there isn't a standard method of working out if you are sterile or not! Some doctors want to see two clear samples, some say one is enough. Some don't mind non-motile sperm, some won't give you the all clear if there are any, and so it goes on.

Some research suggests that after 20 ejaculations most men will be cleared of live sperm. It's possible to be cleared after a very short time once these ejaculations have flushed the system through. However, many doctors will err on the side of caution, and add an element of time as well as 20 plus ejaculations. The idea here is because a high percentage of men do not return to give a second sample if required, doctors prefer to leave it a little longer than strictly necessary so that the vast majority of men can be given the "All clear" after one sample. There is a variation in procedure from doctor to doctor on this - check with your doctor.

Non-motile (dead) sperm will appear in the ejaculate for some time on occasions. The reason for this slowness is that some men have large seminal vesicles and small ejaculatory ducts. Some studies have been carried out on "Distal flushing" using saline solution as part of the procedure, however the results of these studies don't suggest that this clears out the system any quicker than the natural process.

Our online survey looks at how long it takes to become sterile, and how many samples this takes, and the medical journals section has information too.

You are not sterile until the doctor says so having analysed semen samples. Therefore other means of birth control have to be used until you are declared sterile by the doctor. There have been many cases of babies conceived after a vasectomy due to adequate precautions not being taken until the man has been declared sterile.

How do they do sperm tests?

What doctors test for differs between semen analysis for infertility and semen analysis post-vasectomy. In both cases you have to provide a semen sample in a sterile container (usually by masturbation). With infertility, the test is to actually count how many sperm are present in a sample and the quality of the sperm. This process is done in a laboratory and is much more scientific than the process used for post-vasectomy semen analysis. Post-vasectomy semen analysis is usually examination of the sample under a microscope to assess sperm presence and motility. This can be done either in a laboratory or by the doctor in his office. So don't be surprised if your doctor disappears into a back room with the sample and five minutes later gives you the all clear!

For more information we recommend this explanation of semen analysis terminology that also lists what is normal according to the World Health Organisation. Also, the medical journals section has information on how sperm counts are done, and there is also some information in the advice from the newsgroup section.

Do all men submit samples?

Surprisingly, No! According to the Journal of the American Board of Family Practice, despite knowing that without confirmation of sterility they could still get their partner pregnant, up to 42% of men didn't return for post vasectomy semen analysis. Older men were more likely to submit samples than younger men. Common reasons why this may be so include men feeling inconvenienced or embarrassed, forgetting to do it, or they are certain they are sterile. It can't be stressed often enough how important it is to prove you are sterile before having unprotected sex.

When I got told I was now sterile, I felt sad - how usual is this reaction?

Fairly common, but usually it's only very temporary. It usually is just a momentary pang that disappears after the celebratory first un-protected sex! The average ejaculate is 5cc, of which 3% approx. (0.15cc) is sperm. This may not sound a lot, but it *does* mean a lot to us guys! No matter how sure you are about not having any/more children, this reaction can hit you when faced with the finality of being told "No more fertility".

We have also heard of men who experience a sense of loss or change immediately after the vasectomy. Sometimes this feeling can last a while, but in the main will gradually fade as you become used to being sterile.

How can I be sure I'm still sterile?

This question is frequently asked - it is something that worries some people. As in the above question, if it worries you then ask your GP for a test. There has been discussion in the group about using home microscopes to test it yourself, but unless you know what you are looking for then it's probably better to ask your doctor. There is also the option of a home sterility kit that works like a home pregnancy kit.