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Good Followup but Failing Pouch Adhesion
The good news: At 16 months post-surgery and 18 months post-chemo for T2 bladder cancer along with prostate cancer, I’m clean so far.
The not-so-good news: I’ve used Coloplast’s Assura 14717 urostomy pouch on a lower right quadrant stoma since my surgery (bladder & prostate both gone) 16 months ago. For the first 14 months post-surgery I had no pouch problems at all–good adhesion with average wear time just at 6 days (yes, I kept track). For the last two months, though, with no changes in procedure or supplies or body shape, I’ve been springing leaks left and right, almost exclusively at night whilst sleeping. My average wear time is down to 1.5 days/pouch.
I use Unisolve adhesive remover, wash carefully with plain Dial, dry carefully, use the same skin prep, and warm the pouch top before pressing it over the stoma. Again, no changes in procedure or materials of body shape/weight. At night I plug a drain tube into the valve of the pouch, and there’s plenty of slack in the tube, and drainage appears to be OK.
I can’t figure out what the heck is going on with the increased frequency of leaks. Anyone have any ideas? I called Coloplast and they sent me another box of pouches, and I’ll start using them when my current pouch pops a gasket. Maybe it’s a bad couple of pouch lots? Anyone run into that?
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8 Replies
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Thanks, Mike, but I’ve got and wear a pouch support belt. What I’m looking for info on is different, a hernia support belt, maybe like this: http://ostomycareandsupply.com/whatsnew01.html (down toward the bottom of the page).
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Belt- I wouldn’t be without mine. It was a little over a year before my stoma nurse & I tried the Hollister 8488 bag which have the attach points on either side for the belt. So my bag requires a barrier ring such as the Elkin and a belt 7299 or 7300. I like to limit my wear time to 4 or 5 days. I have been leak free for over a year. I think the belt helps hold my bag against my body when I go to bed. My body changes shape in bed.
I surfed pictures of your bag and mine but neither shows the hookup points for belts. I’m guessing they are pretty similar.
I’m 70, retired heat/air contractor. After 4 months of keymo ileal conduit (IC) surgery removed bladder & prostate May 2010
Well shoot. Managed to blow away a post. I’ll try again, this time shorter.
This afternoon I was diagnosed with a peristomal hernia, which is apparently causing the leakage problem. The urologist made an appointment for a consultation with a surgeon, but I’m also researching non-surgical treatments, like hernia support belts. Does anyone have any experience with them?
I’m trying the Eakins seals, as Barbara suggested, and it seems to help a bit. I finally got back online today after nearly four days of power outage at 90+ degrees out here in the boondocks, and found a couple of demo videos about the seals so mebbe I can put it on right the next time! :) If I can get back up to 3 days per pouch (as compared with my previous 6-7 days) I’ll be a happy man.
60 miles away- wow! You are not alone having your stoma nurse so far away. Mine is just a mile or 2 away. My first year or two were really important with guidance from my stoma nurse. I used phone, email (with pictures) and appointments. I was seriously intimidated by the stoma. I was afraid I would injure or damage it. It turns out it is pretty sturdy.
I often wonder about the possibility that a retired wound specialists nurse might be just a few blocks away and connection just doesn’t happen. I wonder about Craigs list or pennysaver to find someone closer…?To be much more practical we are online here and can share our past experiences.
Several have expressed how great the Eakin seals are for them. I might try some.
I’m 70, retired heat/air contractor. After 4 months of keymo ileal conduit (IC) surgery removed bladder & prostate May 2010
Brief update: I called ConvaTec and they’re sending me free samples of several sorts of Eakins seals along with some other stuff, so I’ll be able to try that out.
One suggestion was that I may have a peristomal hernia, so I’m making an appointment to have that checked.
Mike, Barbara,
Many thanks for the responses. I’d not considered seals–I didn’t even know they exist! (My stoma nurse is 60 miles away, and I met her for only 30 minutes a few days after my surgery). There’s no one local.
I’ll try both Mike’s vinegar and water cleaning idea and Barbara’s seal suggestion.
Again, many thanks!
RBH
hi
Have you tried Ekin Seals? They work wonders for leaks. I too had the same problem and someone suggested the seals and I have had maybe 2 leaks in about 3 years.
Good luck
Barbara
Dx 4-28-08
pT3a no mo
Rc with Ileal Conduit on 6-09-08
2nd surgery on 6-27-09 for ureter leak
Renal failure on 7-01-09 nephy tube and then stent on 7-09-09
so far so good
Your assure 14717 looks much like my Hollister 8488. You might want to check with your stoma nurse first but I found from time to time my skin would be tacky and unhappy with the bag adhesives and routine cleaning. My stoma nurse suggested a 4/1 mix of vinegar/water. This neutralizes the skin. I now use it on every other pouch change.
A day & half is not so good. I am comfortable with 4 day cycles. I date mine with a magic marker.
I’m 70, retired heat/air contractor. After 4 months of keymo ileal conduit (IC) surgery removed bladder & prostate May 2010Sign In to reply.
