These Peri-op instructions apply to Spermatocelectomy, Epididymectomy, Hydrocelectomy, Orchiopexy, Orchiectomy, Transcrotal Varicocelectomy, and other transcrotal surgery. For vasectomy please see our brochure specifically for vasectomy.
Because the scrotum is a low pressure sac that hangs loose from the abdomen it is more susceptible to bleeding from very small blood vessels than other surgical sites (surgery of the abdomen is less likely to bleed because there is more pressure on the incision and deeper tissues compressing the blood vessels). Therefore it is very important that for the first three days after surgery while these small blood vessels are healing closed you engage in virtually no activities at all. These tiny blood vessels quickly seal themselves with vasospasm and a blood clot (the body's natural way of stopping bleeding) so that they are not actively bleeding during or immediately after surgery. But with no pressure to keep them closed these blood vessels are easily broken open with even minimal activity or straining. For three days after surgery don't pick up anything heavy or go walking. Hard work or straining (athletic pursuits or heavy lifting) is not recommended for two weeks. Most patients should wait to have intercourse for a week after the procedure (you should feel no discomfort with intercourse or ejaculation).
Pre-Operative Instructions for scrotal surgery:
You should thoroughly shave the scrotum the day prior to scrotal surgery. Refrain from taking any blood thinning agents for 10 days prior to the procedure. Tylenol is okay but do not use Motrin or Advil (Ibuprofen) or Aspirin products. If you are having anesthesia for your procedure (it is not being done in the office) you should have nothing to eat or drink after midnight the night before surgery.
Post-Operative Instructions for scrotal surgery:
Diet: You may return to your normal diet as soon as you arrive home.
Activity: Your physical activity should be very restricted the first seventy-two hours. During that time you should remain relatively inactive, moving about only when necessary. During the first 14 days following surgery you should avoid lifting any heavy objects (anything greater than fifteen pounds), and avoid strenuous exercise. You could work at a sedentary job during this time but not a physically demanding job. We will write a note to your employer if needed.
You should plan to wear a snug pair of jockey shorts or an athletic support for the first 4-5 days, even to sleep. This will keep the scrotum immobilized to some degree and keep the swelling down.
Ice packs or a bag of frozen peas should be placed over the scrotum for the first 48 hours, on and off. Frozen peas or frozen corn in a Ziploc bag can be frozen, used and re-frozen. Fifteen minutes on and 15 minutes off is a reasonable schedule. The ice is a good pain reliever and keeps the swelling down.
Wound: In most cases your incision will have no bandage and the wound will seal closed in 1 or 2 days. Some patients will have absorbable sutures that will dissolve within the first 10-20 days. In either case you can shower safely within 48 hours. You can swim and bathe after 7 days. The scrotum will possibly get "black and blue" as blood in the tissues spread. Sometimes the whole scrotum will turn colors. The black and blue is followed by a yellow and brown color. In time, all this coloration will go away. This is all normal. If there is generalized redness, especially with increasing pain or swelling, let us know.
You may see some sutures dissolve and fall off before the wound is completely healed. This is fairly common with scrotal surgery. If this happens you may see gaps open in the scrotum. These gaps almost always heal and close without difficulty because of the excellent blood flow to the scrotum. If such gaps or openings in your incision do occur, please bring this outcome to our attention for proper observation. Occasionally when this occurs, special dressings (steri-strips) can be applied if needed to re-approximate the wound.
You should have a post-operative wound check-in at the office about 1-2 weeks after surgery. Call to make this appointment.
After hydrocelectomy and orchiectomy in particular, but to some extent with any surgery, there is usually some swelling and bleeding in the scrotum post-op. This collection of fluid or blood will often harden into a firm mass in the scrotum, almost like another testicle. This firm collection or mass may take months to soften, reabsorb, and resolve. Following our instructions about minimizing your activities will help to minimize this issue.
Medication: You may take Tylenol (acetaminophen) for pain. It is the safest of all the pain relievers, in that it causes no bleeding. Aspirin, Advil and Motrin (ibuprofen) may prolong bleeding so Tylenol is the preferred pain medication choice.
Problems you should report to us:
- Fever of 101.5 degrees Fahrenheit or higher
- Drug reactions such as hives, a rash, nausea or vomiting
