NO-SCALPEL VASECTOMY - EngenderHealth

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Management of Complications Participant Handbook Overview of Complications Serious complications related to vasectomy are rare, and those resulting from NSV are even rarer. The possible complications from standard vasectomy and NSV are the same, and most complications from vasectomy can be prevented. The most commonly reported complications are small hematomas and skin infections, which occur in fewer than 3% of cases. The management of most potential complications is similar to that for other types of minor surgery. Side Effects and Complications Side effect: A consequence of a procedure, contraceptive method, or medication other than that intended. A side effect does not require exceptional intervention, but it may require attention and management. Side effects of vasectomy are anticipated consequences of the surgery, such as soreness, swelling, and bruising. These do not require exceptional intervention, but you may need to reassure the client about them. Complication: An unexpected condition that requires intervention or management beyond what was planned or what is normally provided during routine postoperative care. Potential Complications of Vasectomy • Potential intraoperative complications include vasovagal reaction (neurocardiogenic syncope), lidocaine toxicity, and injury to the testicular artery. • Potential postoperative complications include bleeding, hematoma, infection, sperm granuloma, chronic testicular pain, infectious and congestive epididymitis, pregnancy in the client’s partner, and vasectomy failure. Prevention of Vasectomy-Related Complications Most vasectomy-related complications can be prevented by: • Carefully screening clients • Following proper infection prevention procedures • Using a gentle surgical technique • Achieving hemostasis during surgery • Ensuring that clients understand instructions for postvasectomy care • Verifying that clients understand the need for postvasectomy contraception 94 NSV Curriculum <strong>EngenderHealth</strong>
Participant Handbook Management of Complications Management of Intraoperative Complications Table 10-1. Potential Intraoperative Complications of Vasectomy Vasovagal Reaction (neurocardiogenic syncope) Symptoms • Fainting • Nausea • Weakness • Lightheadedness • Blurred vision • Sweating • Decreased blood pressure • Initially increased heart rate in, then decreased • Pallor • Cold, clammy hands • Restlessness Treatment • Reassure the client • Raise the client’s feet • Lower the client’s head • Administer atropine if the client’s pulse is lower than 40 • Administer oxygen Etiology • Painful procedure • Anxious client Prevention • Use gentle surgical technique • Perform effective anesthetic block • Explain procedure to the client in advance • Reassure the client during the procedure Lidocaine Toxicity • Numbness of tongue and mouth • Lightheadedness • Tinnitus (ringing in the ears) • Visual disturbances • Slurred speech • Respiratory depression • Respiratory arrest • Myocardial depression • Arrhythmia • Hypotension • Cardiac arrest • Convulsions • Coma (very high overdose) • Discontinue use of the drug • Take general supportive measures • Maintain airway and respiration • Provide oxygen • Administer diazepam or thiopental (for convulsions) • Administer vasopressors (e.g., norepinephrine or dopamine) for hypotension • Overdose of lidocaine • Intravascular injection • Do not administer a dose >30 cc of 1% solution or >15 cc of 2% solution Injury to Testicular Artery • Bleeding observed in fascia around the vas • Perform cautery or ligation to control bleeding • Injury to blood vessel during stripping of fascia from vas • Strip fascia and blood vessels carefully <strong>EngenderHealth</strong> NSV Curriculum 95
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NO-SCALPEL VASECTOMY C U R R I C U
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MODULE 4 Counseling and Informed De
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Appendix B NSV Clinical Skills Chec
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Overview of Vasectomy Participant H
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Anatomy and Physiology Participant
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Participant Handbook Bibliography B
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NO-SCALPEL VASECTOMY - EngenderHealth

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