@Mchambers One way of looking at the issue of going 24/7 is that if you are wearing adequate protection and can change when you need to change, then you will dramatically decrease the chance of an accident that wets your pants. Believe me, that should be able to help you overcome any mental hurdles about wearing diapers all of the time. You will feel better because others are really not going to notice what you wear under your pants while there is a chance they'll notice if you are wet.
Whether or not you need to wear diapers 24/7 is a question only you can really answer though it sounds like you do need to. Please don't dehydrate to control, you need water. I dehydrated some and ended up with a kidney stone--now I stay hydrated though more incontinent. Like you I have some urge incontinence, it was disconcerting to suddenly realize you have to go and then start peeing without control. I am now used to that and, if wearing adequate protection, I am fine with sudden urges.
I wasn't as young--my incontinence came with prostate problems followed by surgery for prostate cancer and I am now in my 60s. What I did when I realized that I wasn't going to be able to stay dry without padding was throw away my underwear, made a big switch to Depends or NorthShore GoSupreme pull ups (daytime) and diapers (at night). Like others, I am happy with my decision because I can focus on what is important rather than not peeing in my pants all the time. My wife is very supportive.