Any of you with a K-pouch find that sometimes over the years the stoma will stricture a bit.
Mine has. And Dr. Bauer in NYC says to continue to use the Medena French 30. He says if you use a smaller catheter, it will stricture even more. I can get the tube in fairly okay...it is just a bit sore around the stoma.

Hi Bodoni,
I hate it when I post and no one answers me...so...when they did my 3rd and 4th valve repairs, my vlave sunk when the sutures were removed and the skin over the valve started to close..litterally heal over...with the first because the stoma/valve were tilted it acted like a stricture and narrowed...what I ended up doing was using a local anesthetic cream for 5 mins pre dialation and then inserting the tube to stretch the opeing...
With the next one the whole thing sunk and I had a narrowing of the cannal as well as the skin closing over..the plastic surgeon told me the same thing (although he did do 2 double z plasties) to use a local anaesthetic cream to freeze the area before intubating..but to not use a smaller tube..
Hope that this helps..ps, there are these really neat 'thingys' by coloplast that look like a mushroom..they are a stoma cover with a sort of flexible 'tampon' attached...you put the tampon into the stoma, there are 2 sizes, and you place the self-sticking cover over it..the tampons expands and gently stretches your stoma (they are pre lubed), they are short enough to not open the valve but long enough to keep your canal open..plus they are really gentle...I used them when mine sunk and leaked...check it out..it may be a useful solution for you..
Sharon

I have noticed the same thing over the last few years. At one point it hurt somewhat to put in the catheter, and I went to a doctor. He thought that the pouch might be inflamed, so I used cortisone suppositories for a while, and it seemed to help. But, in general, my stoma is shrinking, and I worried about it. Good to see it's nothing to get too excited about.
Monica

I had surgery in December and I have a tiny stoma and it's kind of inverted...looks more like a bullet hole. I use a Marlen 30 french. The bullet nose makes it much easier to insert and is not as rigid as the Medena (more of a flexi tube). You might want to give it a try. It only has 2 holes, but i've tested both and I get the same results. Also understand that the Marlen is gentler on the valve.

Of course it's your preference so please only take this as a suggestion.

Susan

Hi...Have you ever tried to use a 34 Fench Marlen ..larger diameter, but tapered/bullet end...holes seem larger than on the 30 french marlen...use lot of surgical gel..go slow and after a few times, may be able to intubate and also keep the stoma opening from shrinking...also, as the surgeon mentioned, maybe just continue to use the medena, but with lot of surgical gel..seem there must be a better way to manufacture these catheters..i find that th edges are relativly sharp seeing as they are meant to pass through intestinal mucosa...I think they (manufacturers) would or could come upo with a better design that does not have sharp edges where the openings are at the end that goes into pouch...Take care...

I like my 34 Argyle airway, soft but rigid enough to help open. Rounded, tapered end like finger with no holes. Maybe try a 30 or 32 first. And, I don't need lube either.

I've been told to put new tube ends into a pot of boiling water to soften up the edges or to burn them skightly and then smooth them down...messy but it works.
sharon

I just discovered something that works for this!! I was having trouble with a lot of scar tissue at the skin/entry level of my stoma. In an earlier note I learned about the airway catheter which I used- but it is too short for me. I use a Marlene 30-- which works great for me. But, I took the airway catheter- it has a plug end-- I cut it down to the size I need - about an inch, and am using it as a "plug"! I cover my stoma with a Mestopore bandage-- so that holds the "plug" in nicely!! It has kept it open- I leave it in all day and take it out at night to sleep. At first it hurt a little- but it is so short that after the first couple of hours I never felt it! I also put some pain ointment at first so it wouldn't hurt!
I had a surgery for this in August and thought I would need another one-- but this is working so great-- I don't think I will need one. Also, the airway catheters come in many sizes...
Let me know if anyone else tries this and it works! Have a good day, Karen

whatever works, with us ... adaptability is key!