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Fistula Repair surgery???

I have a decision to make regarding a fistula repair surgery and I would love to hear anyone's thoughts/advice.

I have had a persistant rectovaginal fistula for quite some time. I had it surgically repaired in August 2006 and within a little over a year, it was back. I take a low dose of flagyl to keep the inflammation down and that seems to be the only thing that works...as soon as I quit the flagyl inflammation and drainage return. Then I have to take mega doses of cipro and flagyl for a month to get it back in control. I have tried Remicade and Imuran and neither has worked for me. I am currently on 500mg of flagyl/day.

I saw the surgeon today and she said that the tissue around the fistula looks pretty good, only that it is mostly scar tissue. She said that she can do the flap repair surgery (this is a minor outpatient surgery) but is only about 70% certain it will work, i.e. fix the problem for good. (BTW, she is not the same surgeon who did the first surgery that ultimately did not work.) Because there is mostly scar tissue, it makes it harder for the new tissue to "grow". Aside from cost and time of recovery, having the surgery could cause more diseased tissue to form, so that is my risk.

So here are my options: continue to control the inflammation with flagyl (still not sure I like the implications of taking this drug long term even though she assures me it is safe). This will not likely ever "close" the fistula either, just stop it from draining and being sore. Or have the surgery which is 70% likely to be a long-term cure, but could cause further complications in the future.

Any thoughts or advice are greatly appreciated!
 
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