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Ted, I'm new here but not to your kind of problems. I've fought urge incontinent for over 20 years and it only got worse all that time. At some point you are just going to have to sit down and think about what it is you want as an end result. Do you want to be out of diapers for good, do you want to live without any more pain/discomfort, is some anxiety ok or not at all, maybe you just want to be able to get a full nights rest (wet or dry), do you want to live without ever having to even worry about peeing again, and so on (just a a few examples). Once you figure out what you want the most and put that as your top priority. Add on one or two other things you'd like have as well, but don't start hoping or expecting for too much. Know that you may have to throw out or ignore that second or third goal in order to get the first one.
Now that you know what you want as an end result, you have to now consider how far are you willing to go to get that result. Is a major surgery out of the question, how about pills for the rest of your life. Opposite of that is figuring out what you are not willing to consider, maybe that's trying your 100th different pill, yet some other cheap technique, exercises, logs, or maybe you're tired of that old wait and see approach doctors always like so much. Once you figure all of that out, now you need to go to your urologist and talk about it with him. Be frank and open about it, and make sure you tell him exactly what it is you are wanting, and exactly what you are wanting to do (or not do) about it. Hopefully your doctor will respect what ever your wishes are and lay out your options for you both to pursue. If he still wants to try something else then just put your foot down. Tell him it's your life, your health, and your well being. You are tired of "try this and see if it works", and you desperately need to improve your overall quality of life even if that means making a sacrifice or two. (it worked for me at lest).
For me, what I didn't like was have a painful urge hit me every hour or two, always having to worry if I'd even be able to go when I needed to, and waking up at night every few hours because of those same urges. I finally realized I am willing to undergo any test or surgery deemed necessary to first and foremost get rid of my painful urges- completely and 100%. Secondarily I still would like to be able to sleep through the night instead of just getting a few hours ever now and again. The rest I was willing to throw out- and that included coming to terms that I would likely be diapered for the rest of my life. The funny thing, is that after all this time I've actually come to like wearing diapers (yeah I said it). To think I was once so abhorred by them and was willing to live in near constant pain to avoid them. Boy were my priorities wrong back then. Now that I've got them though, both my urologist and I have been making great strides to my end goals.
I'm sure you can as well.
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