This is a very important issue @p414. I reached your stage after being on meds for a few years. I live in the sticks and all the local urologist could offer was surgical removal. No way Jose! I was aware of the risk of kidney damage as described above by @BuddyPish and decided to chance my arm at self catherization in order to relieve the pressure on the bladder and kidneys.
That was over a year ago and it's been so successful that I 've continued using this method. I'm no longer 'toilet hunting' whenever we go out anywhere as I can last for up to 4 hours between pees and importantly I only need to visit the loo once during the night so my sleep has greatly improved. Like you I practice intermittent fasting, nothing after 6pm which also helps and I've also come off the meds which were, by now ineffective and giving me nasty side affects, notably weight gain and edema.
There's a very interesting website right here if you'd like more details and you can PM me if you'd like to discuss further. You should of course also chat with Sheryl about it.