Topic Explanation:
The discussion revolves around the challenges faced by individuals with a urostomy, particularly how weight gain affects the fit and functionality of their urostomy appliances. The original poster has had a urostomy for 19 years and is also dealing with spina bifida and limited mobility due to being wheelchair-bound. They describe how increased belly fat has led to more skin creases around the stoma, causing the flange of the urostomy bag not to fit properly, which increases the risk of leakage. They use Convatec paste to fill in creases and prevent sores, but note that their stoma has become sunken, complicating the fit of the flange even though it causes no pain or discomfort.

Advice and Helpful Insights:
1. Use of Specialized Products:
- Consider using bags with indented flanges and additional tabs for belts to secure the fit around the waist, as this can help achieve a better seal in the presence of creases.
- Explore products like the one-piece Sensura from Coloplast, which features an oval, shallow convex flange designed to accommodate creases and help push the stoma out, potentially improving the fit and reducing the need for paste.

2. Product Adaptation and Sampling:
- It's beneficial to try different products and brands to find the best fit and functionality for your specific body shape and stoma condition. Request samples from manufacturers to test without committing to a full purchase.

3. Hydration and Stoma Function:
- Ensure adequate hydration, as dehydration can affect stoma function and contribute to issues with appliance fit and adhesion.

4. Consultation and Professional Advice:
- Regularly consult with healthcare providers or a stoma nurse to address any changes in stoma appearance or function and to get recommendations for managing weight-related changes.
- Consider discussing additional options like adhesive powders with healthcare providers, which can help manage weeping and soreness around the stoma site.

5. Weight Management:
- Although challenging, especially for individuals with limited mobility, managing weight can significantly impact the fit and function of the urostomy appliance. Explore possible weight management strategies that can be adapted to individual capabilities and conditions.