Standards for Female and Male Sterilization Services - STATE ...

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24Standards for female and male Sterilization servicesb)c)d)e)f)g)h)i)j)k)l)Resume normal work after 48 hours and return to full activity, including cycling,after one week following surgery.Take analgesics and other medicines as advised by the doctor.Resume a normal diet as soon as possible.Keep the operated area clean and dry, and not disturb or open the dressing.The client may bathe after 24 hours, while keeping the operated part of the bodyprotected. If the dressing becomes wet, it should be changed. After 48 hours, thedressing may be taken off.The client may have intercourse whenever it is comfortable after the surgery.He must be told that he does not become sterile immediately after theoperation and that he or his wife/partner will have to use another method ofcontraception or for three months following vasectomy or until the semenanalysis shows no sperms. The client must use condoms if his wife/partneris not using contraception.The client should report to the doctor or the clinic if there is excessive pain,fainting, fever, bleeding, increase in scrotal size, or pus discharge from theoperated site.The client should return to the clinic (in case of conventional vasectomy) forremoval of stitches and post-operative check-up in seven days.The client should report to the clinic for semen analysis after three months.If the client has any questions, he should contact the health personnel or doctorat any time.The client must be provided with instructions about where to go in case ofcomplications (such as infection, swelling of the scrotum, fever, increase in pain,and bleeding from the wound).2.5.2. Follow-up Instructionsa) All clients who undergo vasectomy (both conventional and NSV) should reportto the clinic within 48 hours.b) In case of conventional vasectomy, the client should come after one week forremoval of stitches.c) In both conventional vasectomy and NSV, the client should come for follow-upfor undergoing semen analysis after three months.
Standards for female and male Sterilization services 252.5.3. Certificate of SterilizationA certificate of sterilization should be issued only after the semen analysis shows nosperm.2.6. Complications of Male Sterilization and Their Management2.6.1. Intra-operative complicationsAlthough the incidence is rare, the following may be encountered:a) Transient drop in blood pressure or dizziness due to vasovagal attack: Insuch cases, the procedure should be delayed and the patient allowed to rest. Thehead end of the bed should be lowered and the leg end raised. An intravenousinjection of atropine (0.6 mg) may be given if there is bradycardia. It can berepeated if the baseline pulse rate is not achieved within 1 to 2 minutes. Oxygenshould also be administered simultaneously.b) Convulsions and reactions to local anaesthesia: In such cases, first andforemost, maintain the patency of airway and give 100% oxygen inhalation.If convulsions still persist, injection diazepam 5–10 mg IV may be given.Administration of IV fluids is generally not needed, but may be done dependingon the case. In such an event, surgery should be stopped and the patient allowedto recover. Further surgery should be performed only at a centre with a fullrange of services.c) Injury to testicular artery: This complication is very rare, but if it does occur,first pressure should be used to tamponade both ends of the vessel. Subsequently,both ends of the artery must be ligated.2.6.2. Immediate complicationsa) Swelling of the scrotal tissue, bruising, and pain: These minor complicationsoften disappear without treatment within 24 to 48 hours. Ice packs, scrotalsupport, and simple analgesics may provide relief.b) Haematoma: If small, it can be treated by scrotal support, analgesics, andantibiotics. A large haematoma may need evacuation, antibiotics, and furthertreatment. If a haematoma is detected early, it is desirable to cut the stitches, removethe clots, and look for the bleeding or oozing points, which should be tied. Referralshould be considered.
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