This topic is about a person who, eight weeks after having a colostomy, is eager to resume sexual intimacy with her husband. However, she is concerned about the security of her ostomy pouch, fearing it might burst or leak during the act, especially with her husband on top.

Here are some helpful tips and insights for navigating this situation:

1. Before engaging in intimacy, empty the pouch. A full bag is more likely to leak and can be distracting.

2. If a leak happens, don't panic. Simply hop into the shower together. Normal intercourse won't harm the stoma.

3. Start slowly and stop if you feel any discomfort. Most people find their confidence grows after a couple of attempts.

4. Consider using an opaque or cloth-covered pouch to minimize crinkling noises and reduce any visual anxiety.

5. Secure the appliance to prevent movement:
- Use a regular tube-top or bandeau over your abdomen.
- Try a purpose-built ostomy wrap, like those available on Amazon.
- Some people find that adding light compression with a stretchy wrap helps support the incision area.

6. Choose positions that avoid direct pressure on the abdomen. If you're worried about your partner's weight, side-lying or from-behind positions can be helpful. If possible, being on top can eliminate pressure on the pouch.

7. Consider using bag covers, lingerie, or specialty wraps to make the pouch feel less intrusive and more attractive.

8. Communication is crucial. Discuss any concerns with your partner beforehand to ensure neither of you feels tense.

9. Try to relax and not overthink things. Intimacy often returns to feeling natural once you focus on each other rather than the appliance.

10. For times when you expect very low output, some people use waterproof patches designed for swimming. Others eat a few marshmallows about 15 minutes before to slow down stomal output.