ANN ARBOR, MI - For many men, the first couple of days of March Madness is an ideal time to put their feet up and take in hours of exciting buzzer-beaters and upsets as the NCAA basketball tournament tips off.

It can also be the perfect opportunity to get a vasectomy, since men need to have some down time after the procedure, said Jim Dupree, assistant professor of urology at Michigan Medicine.

Michigan Medicine's surgery center in Livonia has opened extra slots for vasectomy procedures on Thursday, March 15, and Friday, March 16, as well as the following Thursday and Friday, with the expectation of nearly doubling the number of vasectomies it would perform during a typical month.

"We have opened up extra times and slots for vasectomies over this coming Thursday and Friday and the following (Thursday and Friday) and we expect to do somewhere around 40 to 50 vasectomies over those four days," he said. "So this month, we'll probably do 50 or 60 vasectomies, which is higher than a typical month."

Last year, the surgery center performed 324 vasectomies - an average of 27 per month. March Madness appears to be the prime time for men to consider going through with the procedure, which takes about 20 minutes under local anesthesia.

The same trend exists nationwide, according to UM. A 2017 study by athenahealth found urologists in its network performed 30 percent more vasectomies during the first week of March Madness in 2016, compared with an average week during the rest of the year.

During a vasectomy, a urologist blocks or closes the vas deferens, the tubes that carry sperm from the testicles up to the penis. After the vasectomy, the testicles still make sperm, but they are absorbed by the body.

Dr. Dupree spoke with The Ann Arbor News about the spike in vasectomies coinciding with the NCAA tournament and why there might not be a better time for hoops fans to take a couple days off from work while doing some long-term family planning.

Ann Arbor News: From your observations, why is this time of year popular for men to schedule appointments for a vasectomy?

Dupree: We do see a spike in interest around this time of year. I think there are likely some smaller spikes around the time of other major sporting events, but this is the most prominent and the one that gets the most attention.

Vasectomies are outpatient procedures, they are intended to be permanent means of safe and reliable family planning, but they do require a day or two, or maybe even three days of down time, which does not mean men have to be laying down flat on their backs, but it does usually mean that men take a day or two off work. Because we tell them to take it easy for a few days, being able to do something they enjoy while taking it easy is often appealing. For men who enjoy, like I do, the basketball tournament and all of the good games, it provides an opportunity for them.

AAN: Has the procedure evolved through the years? Is it less invasive? Is there a quicker recovery period?

Dupree: I think the most important change that has happened over the years has been the development of the no-scalpel vasectomy technique. It is a minimally invasive technique where we don't need to use a scalpel to get through the skin. The ultimate goal of the vasectomy is to block the flow of sperm from the vas deferens tubes, which are the tubes that connect the testicle up to the penis and the outside body, and these are the tubes the sperm travel through. So we have to get through the skin one way or another to get to that tube to be able to block it.

Historically, and admittedly sometimes now, we've used an incision on the scrotum to get down to that tube. With the development of the no scalpel approach, we use a small, sharp instrument to poke and spread the skin right on top of the vas deferens tube. It makes for a smaller poke through the skin. Studies do suggest that there's a slightly lower risk of bleeding and other complications when using that approach.

AAN: What are some of the general guidelines for men post-surgery, in terms of how long they should be resting and what type of physical limitations they should have?

Dupree: Me and most of my partners will advise men to avoid vigorous physical exercise for about a week after the procedure to allow healing to occur. We also advise them to avoid sexual activity for a week. When they do return to sexual activity, it's very important for men to continue to use birth control. The vasectomy does not work right away, and we remind men of that multiple times during the counseling. It is still possible (for women) to get pregnant immediately following the procedure.

On the short-term side of things, we advise guys to take it easy for two or three days. What that means is that they can go about normal light activities - they can walk, they can climb stairs, they can pick up light objects, usually less than about 10 pounds. I think many men will usually spend the day of the procedure after they get home resting on the couch with their feet up and icing the area where they had the surgery to reduce pain and swelling.

AAN: When should men consider getting a vasectomy?

Dupree: The most important thing is that they and their partner have had a very serious discussion about the size of their family and that whatever that ideal family size is, that they've reached that size. A vasectomy is intended to be a permanent means of family planning.

Vasectomies can be reversed, but that does require an additional surgery, so we really advise men to come into the procedure planning, expecting or at least being as sure as can be that they're done building their family.