*i meant to say 'I don't feel very empty at all' instead of 'I very feel empty at all'

Sally, fistulas seem to do whatever the heck they want to. You don’t have much of a choice about the dilation, since it has now become rather critical. It’s hard to predict how the stretching itself might affect the fistulas, if at all, but the reduced back pressure should help a lot with the problem of which path is easiest. Do you  know if the doctor is planning to use sedation for the dilation procedure?

I hope the procedure goes easily and gives you a great result.

Thanks for replying Scott, they are putting me completely to sleep for the procedure, he said he will dilate and then send me home with a dialatot that I will need to use twice a day everyday.

it just seems to risky, what if the join itself leaks? And with the fistulas he said they are right next to the narrowing so small chance of the fistulas getting larger. Which would be game over for me at keeping the symptoms under bay.

does dialation even work at keeping the area open?

he seems to be saying to me only real option to 'not deal' with the fistulas or the narrowing is to loose the pouch 

*and they are taking biopsies of the thickend area (not of the lump yet tough he said)

We have heard from plenty of folks who do well with dilations. Some have to keep dilating periodically, and some reach a stable point and are able to stop. Just stick with it and hope for the best. Your fistulas make this a bigger challenge, of course, but the highest priority is to be able to poop.

Thanks so much for responding, sorry I've been delayed, I had my dialation and biopsies taken, when I came out of theatre he said he had put a seton in, and said if I didn't like it I could cut it and remove it, well I tried for about 3 days and it felt so uncomfortable really bad, especillay when I had to use the dialator the seton was pulling and it was just to much.

My question is will anything very bad happen by removing that seton? The surgeon did say himself I could remove it, the nurse said try and persevere with it.

before a fistula was confirmed to me it wasn't being very bothersome at al, I just had some discharge and urine, but no stool thank god, can this start now that I've removed to the seton. 

Thank you in advance xxx

The purpose of a draining seton is to keep the channel open and draining. As big a nuisance as that is, it’s worse if it closes off and develops into an abscess. That may not happen to you, and if you run into trouble another seton could be put in. Good luck.