When dealing with a mushroom-shaped stoma that measures 32 mm at the base and 35 mm at the top, it can be a bit tricky to get a snug, leak-free fit with your ostomy pouch. Here are some helpful tips and insights shared by others who have faced similar challenges:

1. Barrier Ring "Wrap"
- Cut or split a standard barrier ring, such as those from Hollister or Eakin. Stretch it and wrap it tightly around the 32 mm base. The ring will swell to fill any gaps.
- Cut the wafer or flange 2–3 mm larger than the 35 mm top so it can slide over easily, then press it against the pre-placed ring.
- It's important that the barrier ring, not the wafer hole, sits closest to the stoma.

2. Double-Ring Method for Extra Security
- First, place a barrier ring around the base.
- Next, apply the wafer or flange cut to fit the full 35 mm top.
- Finally, add a second ring on top of the wafer and mold it snugly against the stoma.
- Marlen Barrier Rings are noted for swelling less and lasting longer. You can request free samples from their website.

3. Pre-Moldable Products (No Cutting Required)
- Convatec Moldable Technology wafers automatically conform to irregular or mushroom shapes. Free samples are available on their website.

4. Large, Pre-Slit Ring Option
- Use an Eakin Stomawrap, a wider, pre-cut Eakin barrier ring, to wrap around the base. Then attach the wafer or bag normally and let the ring fill the size difference.

5. DIY Fitting & Template Tips
- Create a custom template using a thin piece of cardboard or the plastic backing from a wafer. Check the fit with a mirror or phone camera before cutting the actual wafer.
- A cotton swab or Q-tip can help smooth or pinch the cut edge of the wafer to ensure no skin is exposed.

6. Timing / Stoma Movement
- Some stomas "breathe" or temporarily retract. If you can catch the output in a container, waiting a few minutes might allow the stoma to shrink, making fitting easier.

7. Custom Hardware Example
- One user cut a 38 mm hole so the mushroom cap protrudes completely, which helps block output from reaching the skin. They pair this with a 90-degree waste bend and rely on daily irrigation to minimize wear time.

These tips should help you achieve a more secure and comfortable fit for your pouch.