Hi Samantha,
Like you, my issues are largely manageable around the house or running known errands where I know how the next hour or two are going to play out. Like you I typically only wear protection while out travelling or in situations that are not convenient to go to the bathroom within a few minutes of that first urge striking.
It's the longer trips where things are more unknown that cause anxiety. Using protection has resulted in becoming more comfortable using it, and responding more readily when an urge strikes. So yes, while wearing a diaper, every urge that comes along gets passed through to the diaper, sometimes almost unconsciously. When not wearing a diaper I do hold it, and I can hold it beyond the first urge. But beyond the first urge it becomes a crap-shoot. If the urge is bad and painful, and I've been having a lot of them, then the risk of having an accident goes way up. If the urge is not as bad and haven't been as frequent, I can typically wait a bit, though it's seldom more than 15 minutes from the first urge to the point I'm not comfortable risking it anymore.
After almost 3 years of this, my symptoms are stable. I haven't noticed that things are getting progressively worse. There are bad days where the urges are more frequent and more severe, and better days where I have almost no urges.
But as Patrick said, we're not medical professionals. Just people who suffer from similar conditions. If you haven't, you may want to see a urologist to see if anything can improve your symptoms.
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