Second time around

J-pouch in 2014, roughly 8 years with a well functioning pouch.  I think it’s been almost 2 years since I commented or reviewed topics on this site.  I find it therapeutic and should review it routinely to reinforce the fact that other people battle these same issues on a daily basis.   I have been battling rectal fistula for this past 2-year period; 13 separate surgeries and 4 separate Setons installed;  this latest 13th, two weeks ago was a second attempt with an advancement flap to seal up the fistula opening..I was almost believing it worked.  However, as of yesterday, epic fail.  I am all too familiar with the symptoms so back for a post-surgery followup this week where I will break the news to my surgeon.  Moving forward, I know am destined for a bag, my biggest concern is whether to just get it over all at once, I.e pull the j-pouch completely out and permanent ostomy…a reconnect attempt after healing time will likely      result in a complete repeat of the last two years.   Having read several other topics on pouch removal, might opt for going full forward despite the concern for having a permanent appliance and trying to live an active  lifestyle at 53 years old.  The disruption to daily life and pain with fistula is exhausting.