If anyone could offer me some advice I would greatly appreciate it. I have had my j-pouch for 15 years without any problem. Last summer I was diagnosed with an anal fistula from a breech in my pouch. A couple months later I found out that the fistula tract went to my vagina as well. I went for several opinions. My surgeon here in Maryland, as well as Cleveland Clinic and Hopkins all told me to live with the seton as long as I am symptom free. Although there is no definitive test to rule out Crohn's all of my doctors have said I do not have Crohn's. A few months ago my seton fell out and my surgeon thought I was doing well and decided to leave it out. Unfortunately I ended up with a vaginal abscess and so my doctor decided to put the seton back in today. During the surgery, however, he found that the fistula tract to my anus is completely healed and gone. While that's great, that unfortunately leaves me with a seton that goes from my vagina to my anus. It is sooooo uncomfortable and will also keep me from having intercourse. I was told that the next best options were the gracillus muscle flap repair or pull-down pouch advancement. I'm nervous about the success of these options though and I don't want to go back to an ileostomy. Any help?