Your temporary relief with tolterodine suggests an overactive bladder, but persistent urgency can also stem from pelvic floor muscle weakness, chronic inflammation, or nerve sensitivity. Since daily medications only manage symptoms, the urgency returns once stopped. Fortunately, effective drug-free alternatives exist. These include pelvic floor physical therapy and bladder training to strengthen and retrain your muscles. For longer-term relief without daily pills, options like bladder Botox injections or neuromodulation (gentle nerve stimulation therapies) are highly effective. I recommend consulting a urologist to discuss these tailored, long-term options.