Prostate problem, Please Help!!

Hi, I was just reviewed by a urologist after previously having be told that a surgery decision would be made this time, six months ago.

During my last review I was told that the fistula was still there and that surgery would be considered to repair the defect. The urologist seemed hurried and let his nurses finish with me not giving me a chance to discus the matter with him. This time he told me that he would review me in another 6 months time.

Over the last 6 months I have suffered a constant pain (7 out of 10) on good days. I know that surgery is needed to repair this hole and that it will not close on it's own. I have had this since March 7, 2008. I have no idea as to why the urologist is stalling but I'm not prepared to spend another six months in pain.

I would like to propose the following to my family doctor. I would like the next review to be over the next 2 or 3 months. At that time I would like to have a surgery date determined. What do I need to do to have this urologist to decide on what to do. I have been stalled for a year now and things are not getting better, just the oposite.

Is there anything that I can do to have my doctor contact him and have him review me 2 months from now. I'm aware of most of the complications and have taken them in mind. I'm tired of this and would like to put it behind me as soon as possible. I know the risks, but also know that I'm not getting any younger.
To me ther seems to be no sense to wait for something to happen first.

With the fistula between my rectum and prostate, I'm at a constant risk of infections. As far as I know the fistual can't be left the way it is.

Please advise me what I can do the get this needed surgery? Going for a second opinion is out as my regular urologist referred me to this one who deals in reconstruction. He is the only one in my region or for the nex 600km or more. Please help me? I don't know how much more pain I can handle. Due to the pain I have a lot of sleepless nights. If the pain is minimal, I allways have the sensation of needing to urinate and or needing to have a bowel movement. With this I also have some urine leaking from the penis at times. Before this I used to self cath since I have a neurogenic bladder. Even after the surgery, I still will need to self cath. I'm more than aware of this and I have thought things through.
I want to get thins over with. I know that things might not work out the way I would like them too, but that is a risk with any surgery.

Please Help!! Tell me how I can talk about this with my family doctor? Please help? What could be the reason why this urologist is stalling? Please help?!!!

Sincerely,

Ron