Before the MESA/TESE/Microdissection Procedure:

1. Do not take aspirin, Advil, Motrin or any ibuprofen containing medications at least 10 days prior to the procedure. These medications have a side effect that can reduce platelet function and therefore lower blood-clotting ability (i.e. are mild blood thinners).

2. On the day of the procedure, please remember the following:

A) Wear loose and comfortable clothing
B) Do NOT bring valuables or large amounts of money with you.
C) Do not eat or drink anything after midnight on the day prior to your procedure. (Morning medications can be taken with a small sip of water.)

3. If you are to receive sedative medication by vein along with the local anesthesia, it is very important that you arrange for another person to take you home after the procedure. The Hospital WILL NOT allow you to leave without an escort if you have received sedation by vein. If your partner's egg retrieval is scheduled the same day as your aspiration, then an escort will be needed for both of you.

Immediately after the MESA/TESE/Microdissection Procedure:

1. Remove all dressings from inside the athletic supporter in 48 hours; continue with the scrotal support for 3 days total. You can shower the day after the procedure.

2. Apply frequent ice packs to the scrotum the night of surgery and the day after. After 24 hours, discontinue the ice. You can apply moist heat (sparingly) to the scrotum after 5 days.

3. Prescribed pain medication can be taken as directed. Two days after surgery, Extra-Strength Tylenol or Ibuprofen (Advil, Motrin) should be sufficient for pain relief. These are over-the-counter medications.

4. The wound is closed with absorbable sutures. They do not need to be removed. It may take up to two or three weeks for sutures to dissolve.

5. Resume a normal, well-balanced diet when you return home. Start with easily digested soups and broths if you are not feeling perfectly normal. Be sure to include lots of fluids.

6. Normal, non-vigorous activity can be restarted after 48 hours or when you feel better. Activities that cause discomfort should be stopped for the time being. Strenuous activities such as jogging and weight lifting can be resumed in 1 week. You may return to work when comfortable.

7. Refrain from sexual intercourse for 5 days.

8. Please return to the office in 7-10 days for a wound check and a discussion of the findings. Please call 415-392-3200 to make an appointment. If you had a microdissection procedure on both sides, then Dr. Turek will need to monitor your male hormone (testosterone) levels immediately after the procedure and for 6 months afterwards.

9. You may experience discomfort after the procedure. Common discomforts or symptoms include the following and do not require a doctor's attention:

A) Bruising and discoloration of the scrotal skin and base of penis. This will take 7-10 days to go away.
B) Some degree of scrotal swelling. It will peak at about 72 hours post-procedure and resolve after that.
C) A small amount of thin, clear, pinkish fluid may drain from the incision for a few days after surgery. This is normal. Keep the area clean and dry.
D) If you received general anesthesia, a sore throat, nausea, constipation, and general "body ache" may occur. These problems should resolve within 48 hours.

10. Postoperative complications are rare. If the following occurs, you should seek prompt medical attention by calling Dr. Paul Turek or one of his associates at 415-392-3200.

A) Wound Infection. This may be associated with a fever, a warm, swollen, red and painful incision area, with pus draining from the site. Antibiotics are necessary to treat this.
B) Scrotal Hematoma. Extreme discoloration (black and blue) of the skin occurs from bleeding underneath and can cause throbbing pain and a bulging of the wound. This may need to be drained.