This topic is about someone who has been dealing with a urostomy since March 2016 and is currently facing challenges with leaks. They are considering whether revision surgery might be necessary. Here’s a bit more about their situation and some advice that might help:

- Initially, they had success using Coloplast Sensura products without needing a belt or barrier rings, and could wear an appliance for 2 to 3 days.
- They later switched to the ConvaTec Sur-Fit Natura two-piece system due to frequent leaks with Sensura.
- As of summer 2023, in Massachusetts, their appliances last less than 24 hours, leading to frequent public leaks. They are considering using a Foley bag for continuous drainage.
- The stoma has always been described as “pretty convex, cranky.”
- They are contemplating revision surgery because the leaks are affecting their sleep, laundry, social life, and peace of mind.
- Their medical history includes multiple sclerosis, type-2 diabetes, chronic kidney disease, a cystectomy/urostomy, newly diagnosed rheumatoid arthritis, and a recent asthma flare.
- They lost their job last year, their SSDI application was denied and is on appeal, and they are feeling overwhelmed.

They have tried using a belt and both standard and convex barrier rings, but still experience leaks. Since the pouch rarely lasts more than 12 to 24 hours, they are open to trying new products quickly and are willing to retry suggestions.

Here are some pieces of advice and insights that might be helpful:

1. Before considering surgery, try using extra security products. Combine a barrier ring (standard or convex) with an ostomy belt. Some people have found success with Coloplast SenSura Mio, a ring, and a belt, even with a slightly recessed urostomy.

2. Get a professional assessment. Schedule an appointment with an experienced ostomy nurse. Changes in stoma size, shape, and abdominal contours can affect leakage, and a fresh evaluation might help identify the cause.

3. Sample multiple products. Contact manufacturers like Coloplast, ConvaTec, and Hollister to request free samples of different wafers, barrier rings, convexity levels, and pouch styles. This can help find a better fit without extra cost.

4. Keep revision surgery as a last resort. It’s suggested to exhaust all appliance and fitting options with professional help before considering surgical revision.

5. Remember that leaks are common but usually solvable with the right combination of products and expert guidance. Stay persistent and seek support.