Hi Kendall,
I am experiencing the dehydration/lack of thirst issue as you are but I am no longer incontinent, having had surgery to correct it back in 2002.
However, when I become dehydrated, my urine becomes very concentrated (deep yellow or brown) and this is when I have a strong, strong urge to go, it is almost painful like you described. When I do go, I then only urinate about 1/2 cup.
However, when I force myself (because I also, like you, don't experience thirst) to drink a lot of water, I will fill up and then the need to urinate comes from the sensation of a full bladder and not pain. My urine is a then light yellow colour. The full bladder sensation is a lot more tolerable than the pain.
I work a very physical job so when I become dehydrated it starts out with my sweating heavily while working, then the muscles start to get tight and sore, then the need to urinate becomes painful as the night progresses. I hit the head, urinate my measly half cup and continue on. Through this entire time, I experience no thirst. So my goal is to get down four 16 oz. bottles of water during my night. Right now I am doing 1 1/2 and I am still dehydrated. I am working on it. My goal this coming week is to move up to three a night.
Anyway, you need to make a decision and run with it, sounds like to me. I would set a goal for yourself such as going to Costco, buying their flat of 35 count 16 oz. bottles of water and divide the bottles up for one week - 35 divided by 7 days comes out at five a day, and then *make* yourself drink those five per day. Hold yourself accountable to another person if that will help.
I can tell you this, the more water I drink and make a habit of drinking, while I still don't experience thirst, I start craving the water or the habit of sipping it, I don't know which. If you make this a habit, I believe you will notice when you start slipping.
Also, if dehydration is the #1 cause of cancer, then if it was me, I would definitely drink the water and choose the risk of more diaper wearing and using than I would cancer. Wearing a diaper won't kill you, cancer will, plus it's expensive to treat. And yes, I am sort of stepping out of line here because I don't wear. But, sometimes, outside perspective is a good thing.
Personally, I think you are overthinking it. I believe overall you will simply FEEL BETTER by drinking more water. I say GO FOR IT!
