John J. Bauer, M.D.
www.flinturology.com Urology Services, Inc.
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Contents
General information
Pre-operative instructions
Risks and Complications
Detailed Surgery Description
Family waiting instructions
Post-operative instructions
Printing tip: If you want to print only one portion of this entire document, you should be able to do this depending on your software. To print a selection, highlight the section you want to print using your mouse, then click on print, and then in the print menu, choose "selection."
Terminology tip: If you come across words you don't understand, look them up in the On-Line Medical Dictionary.
You will need to complete the Vasectomy Questionnaire [printable format] available at this link. It will help us make the proper diagnosis and treatment plan. [You will need Adobe Acrobat Reader to open and print this document. Free version available]
General information to assist in your Vasectomy decisions can be found on these pages:
Your pre-operative appointments
Before your surgery, you will be seen by the physician and the anesthesiologist, and when applicable, there is a pre-admission appointment with the hospital. Click here to read more details about these appointments, referred to as the Pre-Operative Work-Up.
Change In Health Status
Notify your surgeon if you experience any significant change in your health status: develop a cold, influenza, a bladder infection, diarrhea, or other infection, before your surgery.
Pre-Operative Medication Instructions
Unless specifically instructed otherwise by your surgeon or anesthesiologist, please observe the following guidelines for taking your medicines before surgery:
Pre-Operative Diet Instructions
Unless specifically instructed otherwise by your surgeon or anesthesiologist, patients of all ages must observe the following diet restrictions before surgery:
Patients undergoing operative or diagnostic procedures involving sedation are required to refrain from eating, drinking or taking anything by mouth for a stated period prior to their surgery or procedure. The reason for this is to prevent complications caused by nausea or vomiting while you are unconscious. Should you vomit while in the unconscious state, the risk exists that the vomit may enter into your lungs causing serious complications such as pneumonia. These complications may result in an extension of your hospitalization following your surgical procedure. It is for this reason patients are often instructed to have nothing by mouth after midnight the night prior to your operation unless otherwise instructed by an anesthetist.
Pre-Operative Cleaning Instructions (bathing and showering instructions)
Pre-operative showers are to be taken the night before and the morning of surgery just prior to your arrival. All adults are required to take a shower using either a Betadine or Hibiclens Surgical Scrub antibacterial soap. The reason is to remove as much bacteria from your skin as possible prior to your surgery. If you are allergic to these products please notify your physician or nurse. Perform your shower as follows:
On The Day Of Surgery
The anesthesiologist will discuss with you the anesthetic most appropriate for your medical condition and procedure prior to surgery.
After your surgery you must be escorted/driven home by a responsible adult. You may take a taxi car or shuttle if accompanied by a responsible adult who can stay with you after the driver departs.
Time To Arrive For Your Surgery
During your Pre-Admission Interview, our Registered Nurse will provide you with the correct time to arrive for check-in prior to your surgery.
ARRIVAL TIME:
WHERE TO ARRIVE:
The risks and complications for this surgery are described in the "Counseling and Pre-Op Note" that you will need to sign before the surgery. The main content of that note is listed below.
Indications:
Patient is a male that wishes to be sterilized; he has been counseled regarding the permanence of this procedure and a chance that even reversal at a later date may not restore fertility. Pt has a stable marital arrangement and is finished having children.
Alternatives:
Alternatives are standard birth control measures for both sex partners.
Risks/Complications:
The risks and complications of the procedure where extensively discussed with the patient. The general risks of this procedure include, but are not limited to bleeding, transfusion, infection, wound infection/dehiscence, pain, scaring of tissues, failure of the procedure, potential injury to other surrounding structures including the testicular artery which may result in atrophy or loss of the testicle, chronic epididymal and testicular pain which may be relieved by reversal of the vasectomy and recannalization in the future. Patient is aware that he must continue to use contraception until he has ejaculated 20 or more times and has a negative semen analysis confirming "no sperm seen" if the procedure fails a pregnancy can result and additional procedures may be necessary. If the patient decides in the future that a reversal of the vasectomy is desired there may be a 10-20% chance he will not become fertile again. However, a biological child can still be obtained using artificial reproductive techniques at considerable cost to the patient.
You understand the procedure, general and specific risks as discussed and agree to proceed with the procedure. You also understand that not every possible complication can be listed in this counseling note and additional risks are possible, although unlikely.
To view the actual printable form for this surgery, click here: Counseling Note for Vasectomy. To print the document, simply select print after you have opened the page. You can use that copy to sign before your surgery.
Terminology tip: If you come across words you don't understand, look them up in the On-Line Medical Dictionary.
There are two types of Vasectomy: No-Incision Vasectomy and Standard Vasectomy, both of which are described below.
No-Incision Vasectomy
Indications: Patient is a fertile male that wishes a vasectomy.Sample Procedure Dictation:
The patient was laid in the supine position then prepped and draped in the usual standard sterile manner. Local lidocaine anesthesia was given bilaterally a small stab wound was made and the vas deferens was isolated and cut. It was allowed to fall back into the scotum without significant bleeding noted. The skin punctures were left open to heal primarily. The patient tolerated the procedure well and was observed for approximately one hour. He was able to ambulate and urinate before leaving the office with an escort.
Discharge:
- For initial pain, Tylenol #3: take 1-2 tablets by mouth every 4-6 hours prn.
- For mild pain, take 2 tablets of extra strength Tylenol 500mg q 4-6 hours prn.
- Scrotal support, bed rest for 24 hours and no strenuous activity for two weeks.
- Return to office for severe swelling, pain, fever > 101.5, or chills.
- Return to the office in 6 weeks or after 20 ejaculations for semen analysis.
- Use contraception until cleared by your physician
- Patient was given above instructions and verbalized understanding.
Standard Vasectomy
Indications: Patient is a fertile male that wishes a vasectomy.Sample Procedure Dictation:
The patient was laid in the supine position then prepped and draped in the usual standard sterile manner. Local lidocaine anesthesia was given bilaterally and two small incisions were made and the vas deferens was isolated, coagulated and cut. It was allowed to fall back into the scotum without significant bleeding noted. The skin incisions were closed with running 4-0 chromic sutures. The patient tolerated the procedure well and was observed for approximately one hour. He was able to ambulate and urinate before leaving the office with an escort.
Discharge:
- For initial pain, Tylenol #3: take 1-2 tablets by mouth every 4-6 hours prn.
- For mild pain, take 2 tablets of extra strength Tylenol 500mg q 4-6 hours prn.
- Scrotal support, bed rest for 24 hours and no strenuous activity for two weeks.
- Return to office for severe swelling, pain, fever > 101.5, or chills.
- Return to the office in 6 weeks or after 20 ejaculations for semen analysis.
- Use contraception until cleared by your physician
- Patient was given above instructions and verbalized understanding.
To the family and friends of patients undergoing surgery.
SCHEDULED STARTING TIME OF SURGERY:ESTIMATED LENGTH OF SURGERY:
You should plan to check in at the waiting area information desk as soon as your family member or friend has left for the Operating Room. This is the only way we can talk to you afterwards, or on occasion; reach you to give you updates on the operation's progress. If the surgery is scheduled for many hours, you can leave to eat or do other things, but you should let the information desk know that you are going to leave the area, where you are going, and how long you might be gone so that we might reach you if need be. You should be in the area before the elected time of the end of the operation.
The information deck will overhead page you or the "family of" when they receive the recovery call to let you know that the surgery has been completed. The overhead page system works ONLY on the Surgical Waiting Area and not throughout the hospital or the cafeteria.
We will plan to see you in the surgical waiting area after we have safely completed the early phases of the post-anesthesia recovery in the "Recovery Room" or PAR (Post Anesthesia Recovery). This may take up to an hour after the initial call. Sometimes, especially if another case is ready to start, we will call and talk to you. If for some reason, we have not come or called within 30 minutes, please ask the information desk to page us.
Your family member will be in the Recovery Room for 1-2 hours. This is standard recovery time, although the times vary with each individual. For example, spinal anesthetics take longer to "wear off," local anesthetics are much shorter acting. Under no circumstances are family members or friends allowed in the recovery room. The information deck will inform you of the patient's return to the room as soon as they receive the information that the patient has left recovery. At that time, they will give you the room number and direct you to the correct wing and floor.
Frequently Asked Questions after surgery
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