Diagnosed with an atonic bladder 12 years ago. i only self catheterize when desperate. what can i do except wait for extreme pressure for release?

Physical options: You could try catheterizing yourself on a time contingent basis two or three times a day on a schedule that suits you rather than waiting. An indwelling or supra pubic catheter placed by a urologist is another option. There are electronic devices which stimulate the bladder available, but your age associated risks may preclude that option.