Choosing the Right Urostomy Flange Size - What's Your Approach?

Greetings,

I have a urostomy, only since February. I started out using ConvaTec since that is what the hospital ordered for me. I didn't like how the pouch filled like a water balloon in my pants and their tap is just too obtrusive. I then tried Hollister. I don't like the tap; it's hard to turn. Now I am using Coloplast (SenSura-Mio-Click). I did not like their 'plug' type tap at first, but now, after using it more, I do like it. But I am wondering why one would choose a particular flange size.

Here is my experience with Coloplast, which I am liking more than the other brands. I ordered a sample and they sent me samples with a flange size of 40mm. I liked it at first because the entire appliance is smaller and more compact. But then I didn't really care for it because I could not put my finger between the stoma and the flange to press down the adhesive area close to the stoma. I could use a Q-tip, which kinda works. But I also found that trying to snap in the pouch to the flange was a bit tricky and difficult (maybe because of the smaller-sized flange).

So, then I got a 60mm sample. Plenty of room to put my finger between my stoma and the flange. But the entire appliance was a bit too big. The adhesive area came too close to my belly button.

Then, I got the 50mm sample. Ah...just about right, I think.

Okay, my question. If one's stoma is 1" in diameter, what makes one choose a particular flange size? What goes into that decision to get a particular flange size? I like the 40mm because of the smaller area it takes up but it seems more difficult to add on the pouch. If I use this size, I'm thinking of just joining the flange with the pouch first, then attaching it.

The 50mm seems just about right, but I am just wondering what other people think when they are ordering their appliances, as far as the flange size goes. Do they use that in their decision-making? The Coloplast website does not even mention what the flange size is of their appliances, so you really don't know until you get it.

Gary

Hello Gary.

Thanks for sharing a very detailed description of your dilemma and how you have tackled it so far. 

The thing about this sort of decision making is that it is very personal and dependent on a number of variables (which are often slightly different for each individual). 

It looks as if you are approaching it in a sensible manner and trying as many options as you can to find the best solution.

Most companies will provide a template for measuring the size of the stoma and I found this to be quite useful at the very beginning. However, my stoma changed shape and was no longer 'round', so I needed to cut the flange to suit my circumstances. 

For me, the process of finding a comfortable and effective solution did not stop with cutting the hole to the right size. I found that the flange either cut into the stoma or was too far away to form an effective barrier so I started experimenting with making things (baseplates among other things) for myself. After many failures and 'tweeks' I managed to develop a baseplate that suits my purposes very well. 

It was an interesting journey in which I also developed a deep respect for those technicians who are working constantly to design these things for a population of folks who need bespoke fittings but ( by the nature  economics and business practice) are provided with a simplistic set of pre-made sizes and shapes to suit the majority. 

The companies that recognize this problem also supply a small pair of scissors so that individuals requiring something different can cut their own flanges to the required size and shape. Also, there are several mouldable materials that can fill the gap between stoma and flange.  This is probably as good a compromise as we are likely to get.

Best wishes

Bill

Hi Gary, I'm a little late to the game here, but new to the urostomy team. Your post strikes a chord with me because I went through a similar process selecting the wafer size. I had some 50mm as samples and two 40mm samples (I also use the Sensura Mio Click 2 piece). I thought, like you, it was easier to make sure the wafer was pushed down on the 50, but I really like the idea of the smaller appliance. I am currently using the 40mm and have not suffered leaks or irritated skin. I think the smaller size is more comfortable, so I'll probably stick with it.