A cord with a steel hook on it is attached under the wheelchair. A cam cleat sits on the cord.
In order to pull down his underwear when draining urine the user places the steel hook inside the waistband. Then he pulls the cord until his underwear is down far enough and locks the cord at the correct length with the cam cleat.
The user knew of a similar device with an elastic cord. He refined it with a non-elastic cord and a cam cleat locking device. The solution even works with tight underwear. The cam cleat is an accessory used on small sailboats.
Marine supplies (cam cleat)
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This tip is from 2007