Help with leaks

[Char2019]

I am so glad I found this post! It’s a year after your post. I just had the same exact problem. I have had a urostomy for 15 years and that had a slight retraction within the first year after surgery. I used a Convatec 2 pouch system with a tapeless barrier because I am allergic to the tape on barriers. I also used a convex insert. All was well for 14 years and last year I suddenly had a few more leaks than normal. Not many, but I panicked and decided to try another brand. I first tried Coloplast Assura one piece with convex pouches and they leaked, then I started using Coloplast Sensura Mio Convex one piece pouches six months after that.Now, each month my leaking is increasing. Last week I had to change my pouch four times. My skin was a total mess etc. This has NEVER been a problem with me, not like this. I called Coloplast last week. The representative asked me is it leaking right where the oval part is on the front. I said yes. Then he pretty much suggested it was my stoma, my body, but tried to help. Today I saw my uro, yes the stoma is slightly retracted a little bit more but not terribly so. But funnily enough when I tried my old Convatec pouches with an Eakins seal behind it, no leaking at all for a week now! I’m starting to think that in the last year Coloplast must have produced some bad batches of the Sensura Mio. The Assura Convex is similar to the Mio in construction so maybe those were bad too. Strange how the rep knew exactly what I was talking about, he definitely had dealt with the leaking Convex Mios question before! I’m now sticking with my original Convatec pouches and will see an enterostomal nurse just to double check, but my uro thinks it’s the Coloplast pouches that were the leaking issue not me! I mean this really had me so upset, literally to the point of discussing fixing my stoma via surgery with my uro, then he says it sounds like their product not you!

Hi, your post is helpful. I have a urostomy and have been fine for 15 years. Then recently have had a few issues, leaking being the main one right now. Have a few questions: what is an Eakins seal? Is it the same as a barrier ring? I am going to try the Hollister Adapt CeraRing since I just ordered it. I may try your Convatec two piece system if the barrier ring does not work with the Hollister system I am using. Thanks for a helpful post. I am new to this site.

[MrMatt]

Hi Punkinnae and others. I'm so sorry to hear about your leaks, and can totally commisserate! I have an ileostomy, and would like to offer this advice, after 6 years' experience:

My original WOC nurse taught me this.

When it's time for replacement (best for me is first thing in the morning; less chance of any flow...), I get all the materials together, things unpacked, cut to size, garbage bag at the ready, etc. first. I want the time with no bag on to be as brief as possible! Standing at the sink, with bed protection sheets under my feet and covering the vanity (just in case, you never know!), I remove the bag and flange, and wipe the whole area well with cut paper towel squares wetted with some water so they are damp, cool and soft. I quickly examine the skin-side of the rmoved flange, to see how the seal worked. I don't have any belly hair... (maybe I pulled it all out over the years? ) and there usually isn't any adhesive residue, so my skin cleans with just water. I wave my hands at it to dry it off, and use toilet paper to daub around, close to the ostomy, to dry the area between it and my skin. (As we all do), I have times with partial leaks, not going past the bag ring (therefore unseen, but not un-felt...), and hence some damaged skin around the ostomy). No soap or lotion of any kind, ever.

Once the skin is DRY, I spray (3M(?) non-aerosol) barrier powder on the immediate area, blow off excess (like when baking, and you flour a pan, and tap off the extra...), and daub (not rub) the powdered area with a foam pad of 3M Cavilon barrier film. I wave some more to dry the film that is created well, and do another powder/film appliction. (I have read in the Phoenix mag that your skin will repair itself under the barrier...) Once the film is DRY, I quickly attach the (previously prepared) flange/ring.

I use a Hollister 14603 flange, with a Adapt 7805 barrier ring. I find it important to cut the hole in the flange really, really close to the circumference of my ostomy at the skin line (not to the circ. of the ostomy away from your body, which could be larger). I stretch the ring to make it a little bit smaller circ. than the opening I cut in the flange - as kind of a soft 'gasket' between the flange and ring, to seal the space. When I put this on, the ostomy squeezes a bit inside the ring, but since it's soft, no harm. I press down on the flange well to install it, especially inside the ring for the bag, and all around. I then snap on a Hollister 18183 bag. Now I'm ready for any output. I then press my palms over the whole thing for a few minutes to warm it up so the adhesive and ring form to my skin.

Once the flange/bag is on, I add my secret weapon, discovered last year: a Sure Seal ring. It is larger than the flange and overlaps it, providing an amazingly secure, waterproof leak protection, extending outside of the flange area. It is the same stuff that the hospital uses over intravenous needles on your skin - clear, flexible and impervious to water. And it breathes. It's a bit of a procedure to learn to get it applied, but with practice, it gets easier. Now, when I have a leak, I can SEE it, and have some extra time to address it before it actually leaks out past the Sure Seal! It is quite a sealant, I must say. Increased my confidence many times over since I started using it. Easy to remove, no residue.

I am very fortunate that I can usually go 12 days between flange changes (but also have needed 3 day changes as well...), and I replace the bag every four days. I'm fortunate to have a pretty flat belly; others that don't will probably have more issues, sadly. I can see from the posts here that a colostomy is a different situation altogether.

Hope This helps,

MrMatt