Jim, your doctor has laid things out pretty clearly and completely. Dilation has some risks, and you should understand them before the procedure, but you don’t really have much choice. It might be worth asking if you can reduce the risk by doing it more gradually over multiple, planned procedures, but that does entail general anesthesia multiple times.
As far as your leakage goes, have you ever had a course of Cipro or Flagyl and noticed any benefit? It could just be pouchitis. I’d choose antibiotics over Depends, but that’s just my preference.