Surgery can be iffy for rectovaginal fistulas. Sometimes it works, but other times the fistula just opens up again and you end up with a series of surgeries. So if it's not bothering you too much, you might want to try medication first. Flagyl is usually the first choice, and can work really well. If that doesn't succeed, 6-MP is another option. It seems to close up fistulas in around 30 to 40% of the people who try it. Remicade, too, can be effective, but since you developed the fistula on Remicade, it doesn't seem like that's going to be the ideal treatment option for you. Finally, when fistulas are very small and not too troublesome, some people just decide to live with them.
Anyway, I hope you get some good advice from your doctors at your appointment.
After a topic search, I was so relieved to find this thread! I've been experiencing identical - I mean exactly the same - symptoms as you, Eva Lou!
Mine started as an incredibly bad UTI that just wouldn't go away - after I started having this sort of brownish-pink discharge (lovely!) and sort of a mucus-y discharge, I finally I went to a urologist who put me on cipro and that seemed to work for the pain.
That was about two weeks ago. Since then, I've had some "gushing" as you mentioned - so I've taken to wearing the pantyliners. And it comes and goes - some days, nothing. I realize now that it's really only gotten bad when it's associated with a bowel movement, especially when there's straining. Constipation's never been a problem, but lately that's accompanying it. Once I finally go - it's liquidy and then the discharge starts. Uh, it's so gross. Luckily, there's no odor associated, so I'm wondering if it's a bladder fistular as opposed to rectal.
I've even noticed it will "leak" when I cough or haven't gone in a while (like just before I wake up). It's not painful, as you said, but enough with the sheet protectors and pantyliners!
I stopped Remicade treatments almost a year ago as I began fertility treatments - I still take Pentasa, for whatever good that does. Remicade worked amazingly well - I started it just three months after my Crohn's diagnosis, so I never had time to experience fistulas and other 'extracurriculars' of CD.
I'm really freaked out at the prospect of surgery or heavy duty meds since I'm due to start my first in vitro cycle in January. It's so expensive, I don't want anything to jeopardize it - but at 37, I don't have time to take months off from the process...