I wasn’t sure if I should post my thoughts on this subject line here or in the Sexuality section, being that it involves both, but I thought it may be better received here.
First and foremost, this is an adult issue that most of us here have already explored but I wanted to take a 10,000 foot view regarded what I’ve learned over the years and what works for us. This is very personal (for me) so please be respectful.
I’m very urinary incontinent now but 15-20 years ago, I had much more control. It was like turning on and off a very worn faucet that drips constantly. Point is that I used the toilet quite effectively for a great deal of my urinary needs back then but always needed more than a just a pad for absorption over a period of a few hours, though a single cloth diaper was usually more than adequate, but even then I utilized double diapers a lot for comfort outside. There were however periods of time that were much worse but then would cycle back to minimal leakage again. That was also before the effects of MS.
My husband and I have two teenage sons, one starting college next year(!!), so obviously we worked around my incontinence. We would use an underpad at the time, sometimes with a towel on top of it. I was generally on the bottom, though not always.
Yes, it was messy but we both found great pleasure with our closeness.
Fast forward to today, my incontinence has progressed to what’s best described as a constant leak with urinary retention that relieves pressure quite suddenly in the form of a gush. This gushing occurs day and night which makes many forms of ‘protection’ inadequate in that it must contain a larger volume of wetness very quickly, else leak past the diaper. That generally excludes the use of pads, pull-ups without leak guards, and cheaper diapers. Anything other than cloth diapers or quality disposables with high leak guards are accident prone.
With that said, when my husband and I choose to be intimate, it remains a planned procedure…. Nothing spontaneous

First, I try to utilize the toilet, though my ability to ‘go’ on demand has come and gone for the most part other than for bowel needs in. We use a large underpad and large towel folded somewhat smaller than the underpad. I use plastic pants with snaps for ease of removal. On a very positive side, we both enjoy a lot of time together in bed prior to the actual encounter (foreplay), but when the time is right, my husband will undo everything, pull the front of the diaper down and fold the diaper over for added thickness in case of a gush.
When we’re finished, there’s a damp hand towel close by for both of us to clean up, after which my husband will expertly re-pin the diaper and re-snap the pants. He then rolls up the underpad with towels within and set it aside. We can then enjoy snuggling for awhile before falling off. We mix things up quite often to keep things exciting and fresh but the above process is usually followed to keep our bed and ourselves clean and dry.
I used a catheter for awhile but as you might imagine, that was miserable and didn’t take long for me to say forget this!