It took a long time for my fistula to be diagnosed. (It's snail-paced in Canada as well but I'm grateful that it is paid for. I'd be bankrupt otherwise).
I'm just going to throw this out there. I sometimes wish I had left well enough alone and just tried to manage the fistula. I've gone through so much since that first flap advancement repair. Prior to attempting a repair it was not too bad if I kept the stool on the thicker side and didn't let the pouch get too full. There were periods of time when it would be very active but then it would seem to settle down again. Now not only am I back where I started but the fistula drains much consistently and much more stool into the vagina. The benefit of hindsight. Also, I may not be accurate in my recollection of how it was.