Urostomy, what appliance have you decided works best?

[LarryW]

Hi everyone, this is my first post and looking for advice on urostomy appliances. I am only 4 weeks out from my surgery and I have tried Hollister one piece and two piece appliances, also have tried convatec. I have heard stories of only changing appliances once a week and I'm lucky to go 3 days.
So I'm hoping some of you long time users could share what you use, average length you can wear them and why you ended up settling for a particular one. Larry

[earney y]

Why can you only go 3 days? Is the appliance leaking? If so, where? I have used Hollister products for almost 4 years and until May of this year, had good experiences. I changed every 7 days and had no problems. (Then in May, I started having leaks. I use a two piece product and they all leaked where the barrier and pouch snap together. I have used 37 different appliances and all leaked at the joint. Hollister doesn't know why. They have been of little help. I like Hollister products - my skin becomes irritated with ColoPlast and ConvaTec.) If you are leaking at the joint, it could be a problem with their product in my opinion. Call them and ask to talk to a WOCN. I talked to Lynn and she was helpful - I think her number is 888-808-7456 ext 2590. Good luck and let us know what happens.

[smashms]

i have had a urostomy since 2011, i have only ever gotten 3 maybe 4 days out of an appliance. so 3 days is normal for me. when i was first in the hospital right after surgery my WOCN there said 3-4 days is normal for a urostomy. i now get 2-3 days out of 1 if i am lucky i change almost everyday. due in high part to a huge hernia that contains most of my bowel. i have always used hollister 2 piece.

[LarryW]

All the leaks have come from separation at the skin by the stoma. I do have a dip in my skin by the stoma and I think this is where they all start separating. I have not had any problems with leaking from the two piece flanges. I'm using the Hollister 14603 skin barrier now and it has worked a little better then the others.

[tdf]

Have you tried a CONVEX barrier? They are specifically made for dips around the stoma and stomas that don't protrude enough. Coloplast even makes a deep dip one.

Are you getting the barrier material close against the circumference of your stoma when you apply it? It's OK if it touches the stoma. It's not OK if there's space between the stoma and the barrier opening. Maybe you need a smaller opening size. Or maybe you should try one where you cut the opening yourself so you can be sure it matches your stoma precisely. Convatec makes a moldable opening barrier where you massage the opening material with your fingers, sort of like putty, to make it the exact size you need.

If you can solve the problem of the slight leakage at the stoma edge, your other problems should be abated. I change mine every 3-4 days but could usually go 5-7 days. I've never had a leak in two years since my ssurgery.

[LarryW]

Tdf, thanks for the reply! Yes I'm now convinced that the problem is from a recessed stoma and I have been using flat barriers. According to a website I recently visited that asked a series of questions about your stoma, their recommendations was a deep convex barrier. So I have a few ordered and I have heard mixed reviews, but seems most are getting between 5-10 days wear time. Looking forward to trying them!

[LarryW]

Are you getting the barrier material close against the circumference of your stoma when you apply it? It's OK if it touches the stoma. It's not OK if there's space between the stoma and the barrier opening. Maybe you need a smaller opening size. Or maybe you should try one where you cut the opening yourself so you can be sure it matches your stoma precisely. Convatec makes a moldable opening barrier where you massage the opening material with your fingers, sort of like putty, to make it the exact size you need.

I am only 5 weeks out from my surgery and I am still using cut to fit appliances. I get them as close as I can to the stoma. I must say that I keep reading mixed opinions as to what is acceptable. I have read you dont want it to touch the stoma and touching the stoma is ok, it's ok to have a little gap because the moisture from the stoma will swell the appliance against it and you dont want any skin showing. Gets a little confusing as to what is and isn't acceptable.

[ot dave]

I have a colostomy, so a different situation, but I always try to leave an 1/8" clearance around the stoma. This helps to create a good seal for the flange material as the stoma is always moist with mucous. Constant moisture usually creates weak spots in the flange. I think you are on the right track with getting convex flanges. I haven't seen it recommended yet, but I might also try using a barrier ring. Eakin seals, adapt barrier rings, etc. They are made of a pliable hydrocolloid material, and they act like an o-ring in a garden hose. They go around the stoma, on the skin, under the flange, and help seal off the area around the stoma. Sometimes you only need to use a small piece to fill in a dip or a divot. I use 1/3 of a ring at each change for a dip at the 7:00 position on my stoma, and it works great, increasing my wear time from 2-3 days to 7. I could get a few more days of wear time, but I like to check my skin once a week to ensure that it is good and healthy and address any issues that may pop up under the flange. Hope that helps.

David