I have had a R/V Fistula for coming up to two years now. Are there any implications for fistulas going untreated? Is surgery used to treat the condition merely because it is distressing or are there any medical implications?

I would say "welcome to the club" but it's not a club any of us would like to be part of. There have been a lot of discussions about R/V fistulas on this site.
There is a discussion titled, "Fistula Gals won't you come out tonight." I've included the link below; you'll probably find a lot of info from there.
I had the dreaded R/V fistula but I didn't have a choice in leaving it untreated. I ended up getting quite ill with fevers of 105 and higher due to all the drainage going places it shouldn't. My fistula was quite large though and I had major surgery to repair it. As far as implications go...I'm not sure, perhaps, Jan, our resident expert in EVERYTHING could answer that one. Check out the link though, you might find some of your questions answered.

Good luck and feel free to PM anytime if you have specific questions for me regarding my R/V fistula.

http://j-pouch.org/eve/forums?a=tpc&f=3451071921&m=8581011202