My fistula is perianal, not RV. However, my surgeon won't touch me to repair it. He says our sphincters have already taken a hit from the surgery, and that messing in there now could leave me with some incontinence.
I'm completely continent, with hardly a nighttime trip to the bathroom and zero seepage, so I accept his viewpoint. I live with a seton. He said we could periodically remove it for a break, if I want.
I know RV fistulas are different, and their repair likely doesn't affect the sphincters like a perianal one, but it's surely a question you might want to ask about.