I had UC for 7 years before I had the j-pouch surgery a few months ago. I was just like you, tried a bunch of meds and nothing helped, not even prednisone. Pred would help me a little by reducing the frequency of my bathroom visits, but never completely controlled my symptoms. As soon as I got to a low dose all my symptoms would come back with a vengence. I was never in remission and I got weaker and sicker every year.
Looking back on all of it now, I wish I had opted for surgery years ago. It would've saved me so much time and pain. My GI had been suggesting surgery for a few years prior, but my family was extremely against it so I waited. And then one ER visit I decided that I was done waiting.
Surgery is something you have to decide for yourself, but if prednisone isn't helping you need to look into your other options. Speak to a surgeon if you can, it'll give you a better idea of the whole process and whether or not it's something you're willing to do. A consult doesn't bind you to anything, you can always change your mind.
For jpouch surgery, the colon and rectum are removed (only 1-2cm of rectal tissue remains). The jpouch is created out of 9inches or so of small intestine and acts as a false rectum. I had primarily rectal disease and like you was worried about urgency but after a suitable recovery there is no urgency with a jpouch. There also is no pain, discomfort, bleeding, or general feelings of malaise. My health and activity returned to 100% after surgery.
I would ask your GI to schedule you for a surgery consult. Once you've met with a surgeon, you can decide if and when to have surgery. After 7 years of dealing with Crohn's in my rectum, I was also "sick and tired of being sick and tired" and was ready to have surgery.
It was the best decision I've made. I've never regretted having surgery, because I'm as healthy now as I was before I was ever sick with Crohn's. Plus, I don't have to take any medicine, so there are no side effects to deal with, which is a real blessing.