Go With the Flow
If the soaking hand prank works, then how does it overcome the mechanisms we develop in childhood to prevent bed-wetting (see sidebar)?
Our bodies store urine in the bladder, a muscle bag that retains liquid by relaxing and expels it by contracting. Outbound urine streams through a tube called the urethra. To help the process of retention and release, muscles squeeze the urethra shut at two points: the bladder neck, aka the internal urinary sphincter, and the external urinary sphincter, located a bit further down.
Medically, the trick to overcoming postoperative retention lies in convincing these sphincters to relax. Studies suggest that sitting in a warm water bath or placing a hot water bottle on the pelvis can do just that, likely through a temperature-based sphincter reflex [sources: Elsamra and Ellsworth; Kulaçoğlu et al.; Shafik].
"Heat and warm water is a common relaxation modality," says Valre Welch, a pediatric nurse practitioner and past president of the Society of Urologic Nurses and Associates.
"It encourages blood flow, and it's very soothing after genital surgery."
But would the same reflex hold true when dunking, not the affected area, but a hand or a few fingers? The answer is a firm perhaps, if the paw plunge is combined with a very deep sleep and/or the power of suggestion.
Research bears out the power of watery images or sounds to instill a sense of urinary urgency [source: MUCMN]. Moreover, it makes sense: The inhibition and release of the micturition reflex -- the contraction of bladder walls and relaxation of urethral sphincters in response to bladder pressure -- is controlled by the brain and nervous system.
As pressure builds inside the bladder, the rate of nerve impulses flowing from it to the spinal cord surges. Neurons in the spinal cord then send signals to brain areas called the pons and cerebrum, which make us feel a conscious desire to pee. If for some reason urination isn't in the cards, the brain RSVPs with a polite "no" and signals via the spinal cord for the bladder to inhibit the reflex. Later, when it's go time, the brain sends signals that activate the micturition reflex, and it's a potty in the USA [source: McKinley and O'Loughlin].
During a typical night's sleep, a full bladder kicks off like an abdominal car alarm. It needles us until we wake up and take care of business. But get a little too drunk, stoned or exhausted, and you might just ignore that alarm -- especially if the power of suggestion relaxes you further via a pan of warm water.
"It really does occur," says Welch. "It is a phenomenon of relaxation."
Author's Note: Will putting people's hands in warm water really make them wet the bed?
So there you have it. The hand-in-water trick is no longer a debate with no relief in sight. Or is it? Whether confirmed or refuted, these arguments never seem to die. In the end, if you want to plumb the mysteries of the ages, you'll just have to take the plunge yourself.
- Boyse, Kyla. "Enuresis (Bed Wetting)." University of Michigan Health System. September 2008. (Jan. 17, 2014) http://www.med.umich.edu/yourchild/topics/enuresis.htm
- Elsamra, Sammy E. and Pamela Ellsworth. "Effects of Analgesic and Anesthetic Medications on Lower Urinary Tract Function." Urologic Nursing. Vol. 32, no. 2. Page 60. 2012. (Jan. 9, 2014) http://www.medscape.com/viewarticle/763040_2
- Hagopian, Louis P., Wayne Fisher, Cathleen C. Piazza, and John J. Wierzbicki. "A Water‐Prompting Procedure for the Treatment of Urinary Incontinence." Journal of Applied Behavior Analysis. Vol. 26, no. 4. Page 473. 1993. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1297874/pdf/jaba00014-0066.pdf
- Kulaçoğlu, Hakan, Cenap Dener and Nuri Aydın Kama. "Urinary Retention After Elective Cholecystectomy." American Journal of Surgery. Vol. 182, no. 3. September 2001. (Jan. 9, 2014) http://www.sciencedirect.com/science/article/pii/S0002961001007036
- McKinley, Michael and Valerie Dean O'Loughlin. "Human Anatomy." McGraw-Hill. 2006. (Jan. 17, 2014) http://highered.mcgraw-hill.com/sites/0072495855/student_view0/chapter27/animation__micturition_reflex.html
- Metropolitan Urology Clinic (Minneapolis, St. Paul). "Do You Have an Overactive Bladder? (Urge Incontinence)." (Jan. 17, 2014) http://www.mucmn.com/overactive-bladder/
- MythBusters. "Hand In Water While Asleep Makes You Urinate; Finding: Busted." Dec. 28, 2009. (Jan. 9, 2014) http://dsc.discovery.com/tv-shows/mythbusters/mythbusters-database/hand-water-asleep-urinate.htm
- Shafik, Ahmed. "Role of Warm Water Bath in Inducing Micturition in Postoperative Urinary Retention After Anorectal Operations." Urologia Internationalis. Vol. 50, no. 4. 1993. (Jan. 9, 2014) http://www.karger.com/Article/Abstract/282487
- Welch, Valre, pediatric nurse practitioner; secretary and past president of SUNA, the Society of Urologic Nurses and Associates. Personal interview. Jan. 24, 2014.