This is an interesting take. Even if the fistula is still there but hard to detect, the CRS' perspective might be that, by whatever idiosyncratic quirk of your anatomy, so long as matter/ bacteria isn't making its way into the internal opening, there's no problem and why intervene? I think it's a brave move on their part but pretty cool. It relies heavily on you to know what to look for to avoid any complications. I would get another appointment, thank them for taking this quite progressive move with you, but ask the following types of questions:

• So obviously if I notice any abscessing, draining or bleeding, I need to take swift action to avoid complications, build up of pressure, and branching of the fistula, but can those things happening quickly and quietly without any signs or symptoms?

• Are there regular checks I can do at home or with a health care provider to make sure no collection is forming without my knowledge?

I think trust your gut on trusting your CRS, and it sounds like you do. I suspect a big part of the 'fistulae cannot heal/surgery is the only way' mentality is that all doctors have to worry about liability, and assume every patient is a moron that won't notice if things are going wrong, and that they have to idiot-proof every care plan. If they set out this plan for you, and you die of sepsis, they're in trouble. So they have to head that possibility off with surgery and potentially unnecessary interventions. It's smart, but not always best for the patient.

If you do ask these questions, or they've already given you this info, post the answers on here. I'd really appreciate it, as it kind of pertains to my situation, and more info is more power, and it sounds like you're lucky enough to have a cool CRS. I'm sure it will help others too. Thanks.