647273 tn?1292094741

A doctor's opinion please?

Hi, I have posted something simmilar about a year ago.
Currently it will be three years in March since I was diagnosed with this fistula while I was in hospital in 2008 with a severe kidney infection and pneumonia.
I have been under the care of a reconstructive urologist for the last 2 and a half years now.
Last September I went in for another cystoscopy and once again the urologist told me that he will review my case in another 6 months. While I looked at the screen as he was performing the cystoscopy, I could clearly see the fistula as well as other rough looking areas of the prostate.
The urologist seems to stall things as he states that it will be a major surgery. I was aware of that after my second consultation and cystoscopy. At that time I had alread resigned myself to the fact that this surgery will have to take place.
I kow that this surgery has risks and I know what most of the risks are. It is my hope that I can have this corrective surgery to repair the fistula and that I eventualy can get rid of the suprapubic catheter.
I believe that the following problem causes another area of concern for the urologist. This is the fact that I have a neurogenic bladder for which I have been self cathing since 1999- 2000.
He figgered that the fistula was caused by me doing the self cathing. I believe that if that had been the case I would have been able to feel it.
In 1995 at the age of 30 I underwent a TURP and resection of the bladderneck due to an obstruction in the bladderneck. I think that it is much more likely that this surgery had created a weak are in the prostatic urethra.
The urologist now feels that once the fistula has been repaired I eventually will end up with the same problem again.
My question is: would removal of the prostate illiminate this bad section of the urethra? After all some males with cancer of the prostate, have their entire prostate removed. Would that be an option for me?
If this is not possible, would it not make sense to repair the section of the urethra in which the fistula is located.
In the last year I have had at least four UTI and the beginning of a kidney infection. If the fistula is left as it is, which it seems that the urolgist is suggesting, would it not be the cause of repeated infections.
As far as I can understand, even in the best conditions the suprapubic catheter can be the source of infections.
After almost 3 years of having lived with this, I'm sick and tired of it and I would like to proceed with the repair of this fistula.
What can I do to get the urologist to ge ahead with the repair?

I hope to get a professional opinion from one of the doctors here, but any suggestion is welcome. I would like to restore my life to what is was like before I ended up with this fistula.

Your insight is greatly appreciated.

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