Tuesday, July 31, 2012

Varicocele part 8

Postoperative Details

Patient instructions

·         Varicocele surgery is usually performed in an outpatient setting (ie, day-surgery unit). Patients may return to normal nonstrenuous activities (eg, work) after 2 days.
·         All outer dressings are removed 48 hours after surgery. The small strips of tape (Steri-Strips) are left in place for 7-10 days before removal.
·         Inform patients that bathing or showering is permitted 48 hours after surgery.
·         A normal, well-balanced diet can be resumed when patients return home. Advise patients to start with fluids and gradually return to solid foods.
·         Prescribe pain medication and advise patients to take as directed. After 2 days, patients may take nonprescription acetaminophen (eg, Tylenol) or ibuprofen (eg, Advil, Motrin) to relieve discomfort.
·         Patients can engage in normal, nonstrenuous activity when they feel up to it. If activity causes discomfort, it should be discontinued. Patients can resume more strenuous activities (eg, weightlifting, jogging) after 2 weeks.
·         Advise patients to refrain from intercourse for 1 week.


Common discomforts and symptoms that do not require medical attention

Patients may experience some postoperative discomfort. Complications are rare. Common discomforts or symptoms do not require a doctor's attention and may include the following:
·         1- Minor bruising and slight discoloration may appear around the groin incisions but are self-limited.
·         2- The sensation of hardness around and beneath the incision site resolves in approximately 3 weeks.
·         3- The slight redness and tenderness around the incision from the normal healing process resolves in a few days.
·         4- A very small amount of thin, clear, pinkish fluid drains from the incision for a few days after the procedure. Advise patients to keep the area clean and dry.
·         5- A sore throat, headache, nausea, constipation, and general body ache occur because of the surgical procedure and anesthetic. Advise patients that these problems resolve within 24 hours.


Postoperative complications that require prompt medical attention

·         If wounds become infected (usually 3-5 d after surgery), antibiotics may be necessary. Wounds can become warm, swollen, red, and painful, with significant drainage from the incision site, and patients may develop fever.
·         Hematomas may form. Extreme discoloration around the abdominal incisions results from bleeding underneath the skin, which causes throbbing pain and bulging wounds.


Check the patient's semen 3-4 months after surgery. Because spermatogenesis requires approximately 72 days, any effects from the varicocele repair on semen analysis results are delayed.

Patient instructions

·         The patient returns to the clinical office for a wound evaluation in approximately 7-10 days.
·         Schedule a follow-up examination for a wound check and varicocele examination for 8 weeks after surgery.
·         Schedule a semen analysis and consultation for 4 months after surgery. At this time, the timing of subsequent appointments can be discussed.
For excellent patient education resources, visit eMedicine's Men's Health Center. Also, see eMedicine's patient education articles Understanding the Male Anatomyand Testicular Pain.





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