I wrote 8 months ago that I switched from filtered to non-filtered Sensura Mio pouches after suffering several major pouch leaks which seemed to involve pancaking due to the Sensura Mio pre-filter. Now, some follow-up: After switching to the non-filtered pouches, I haven't had any more leaks. However, I've had several NEAR leaks recently, where, during a regularly scheduled change, I discovered that it was very close to leaking, and a serious leak would have occurred if I had worn it just a little bit longer. Moreover, after reviewing all the data, I've determined that, in addition to the effect of pancaking and the Mio pre-filter, there's a second factor which has contributed to my leaks:

The issue is that SENSURA MIO ADHESIVE HAS A SHORT SHELF LIFE. And, even when it hasn't hit its expiry date yet, if it's sufficiently close to its expiry date it can lose enough adhesion to increase the chance of leaks. Coloplast knows that Sensura Mio has a short shelf life, as they mark each box with a shelf life of only 2 years. (See the post about expiry dates at https://www.veganostomy.ca/ostomy-product-expiry/ and note the photo of box of Sensura Mio 1pc drainables). This is in marked contrast with Hollister and ConvaTec pouching systems, which are considered to have 5-year shelf lives. I've worked through all my purchase records of Sensura Mio pouches, which include the expiry dates of every box. I found that every time I've had a significant leak or near-leak, with either filtered or non-filtered Mio pouches, I was using Sensura Mio adhesive that was within 10 months of hitting its expiry date (or, equivalently, was older than 14 months after its manufacture date).

Given this information, I'd like to be able to instruct my supplier not to sell me any product that's within 10 months of expiring. But that isn't possible (All I can do is make sure they don't sell product which has actually expired). What I'm doing now is choosing how long to wear each pouch based on its expiry date. Previously, I typically wore (one-piece) Mio pouches for 3 or 4 days. Now, I still wear them for 3 days if they have more than 10 months to go before hitting their expiry dates. However, if pouches are within 10 months of expiring, I wear them for only 2 days. I'm also being very careful to always use up older products (by expiry date) before newer products. Thus, if I get a newly purchased box which happens to be older (by expiry date) than a previously purchased box that I'm still using, I'll immediately switch to the newly purchased box and use them up before returning to the previously purchased (newer) product.

While this is working, for now, it's annoying to deal with a product that has such a short shelf life and sometimes get so little wear time. Therefore, as much as I like the Sensura Mio systems, I may hunt around to see if I could use a system from Hollister or ConvaTec with their more sensible 5-year shelf life.

Hi Bob. Thank you for the update!

I can certainly see how that can be a problem and I'm not sure that anything can be done unless the Mio's adhesive formulation is changed. Good luck, and I hope you find a solution that works better for you.

To weigh in on the debate, not that anyone asked me...  I agree with those who have highlighted individual differences as dictating which system is best. 
It was said above that the 2 piece is not an active person’s friend but it is if you have a higher output ileostomy with a long stoma. The flange on the 2 piece serves as an essential part of my stomal protection. My spout is long enough that all the stoma guards I’ve tried tend to crush my stoma and prevent output. The flange lifts the guard off my stoma which is key. I agree that the 2 piece is more rigid and kind of a pain in the ass with deep bending but it’s better than a bleeding stoma surrounded by an exploding pancake! 

interesting JTV.   if you roll over on your stomach at night will the stoma bleed?  mine only seems to bleed when I'm cleaning around it with a paper towel.  of course it could bleed at other times and I do not know it.  is your stoma sensitive to touch? my colostomy isn't,  i can bang on it all day without trouble, grandulomas don't like being touched though.

BOB, how many failures do you find per box of 10 near the 10th month per expiration date?

I recently wore a 8-10yr old convetec and couple weeks later a brand new sample,  the wear times were basically the same from old to new    I really question these so-called expiration dated bags.  really like to see some hard data, not just a manufacturer suggestions.

the Mio was initially a closed end bag designed to be removed daily.   the first drainables, about 8 yrs ago or so came out,  I tried them and they  lasted 3-4days, recently I tried a Mio again and the wear time was about the same as if they are still basically a drainable closed end style flange.

lots of variables i find with leaks,:

how clean was the skin,

how hot did I get the flange

how long I kept pressure on the bag putting it on.

how much bending I do, not a constant for sure.

pinning it down to its manufacture date would require a whole lot of testing. at least 3 - 4 boxes.

@dogtalkerer

I’m not sure about rolling over on it as I haven’t slept on my stomach, even inadvertently, since I was stomatized. I actually miss it. The stoma is very friable and bleeds with cleaning, after a long day under a guard, or even with a waist band that rides up or down without a guard on. I grazed it with a ski pole causing a small laceration and it bled A LOT. It also healed quickly. It’s highly vascularized tissue so all of this is probably normal. No somatic sensory receptors in intestine so no, there is little pain associated with the damage. I do have pain around the stoma and some visceral discomfort but thats a different story. 
I can’t speak to using product near the expiration date as I’ve only had this thing for 4 months. I would feel perfectly comfortable using pouches indefinitely. The wafers make me more nervous but I’ll probably use them beyond their best by date. I did have some freeze on me then thaw with a lot of condensation so I’m saving those for a rainy day. 

On changing the adhesive formulation, the Sensura Mio adhesive has some unique characteristics in terms of its elasticity and flexibility as shown in the video at https://www.coloplast.ca/sensura-mio-1-piece-drainable-en-ca.aspx#section=videos-and-animations_100 and it's possible that in designing an adhesive with those characteristics, one of the trade-offs was a short shelf life.

Posted by: @Bob

and it's possible that in designing an adhesive with those characteristics, one of the trade-offs was a short shelf life

Absolutely. There's always a give and take when it comes to what the goal is with these formulations. It's possible to have a product that's extremely gentle on everyone's skin, but maybe it only has a 24h wear time. Likewise, you can probably design a wafer intended to wear for weeks, but good luck getting that to work with everyone. 

I'm sure that the softer, more flexible Mio wafers (which I also find to be very skin-friendly) have reduced wear times vs. other products. Perhaps in time, their formula will improve to offer longer wear times for more people. 

Firstly, Eric, thank you for your informative, helpful, "no nonsense" site.

Since my APR surgery on 10 February I have been using the Hollister New Image 2-piece system, with its CeraPlus Skin Barrier and a drainable pouch. The skin barrier is excellent: flexible, secure, and I get 5 days wear with no skin irritation. The Hollister "floating flange" makes it easy to get your thumbs behind the flange to press on the pouch and secure it in a pinching motion between finger and thumb. The pouch itself is not so good, however: the non-woven fabric cover roughs up after a couple of days, can get damp in the shower, and the end of the tail is quite hard to clean because of the thin, 1mm or so, floppy plastic that extends past the thicker end of the tail. It does always feel secure when rolled up, though, and the filter works very well.

I tried a sample Sensura Mio click wafer and drainable pouch for the first time at my last appliance change.

The pouch is really excellent: good quality material, good shape, easy to empty and clean the tail, shrugs off water, the tail tucks away, and the pouch can be folded if required. Very good all round.

I'm not so sure about the wafer though: unlike Hollister's "floating flange", I found it very difficult to press hard enough on the wafer when it was on my abdomen to get it to click. It took about five minutes and was quite frustrating. And, it's only been on two days and the outer edges already seem to be peeling away from my skin, which is making me feel slightly nervous. (My skin was clean and dry, with no use of moisturizers or anything like that before I fitted the wafer.). I did also try lubricating the flange with a drop of hair clipper oil to make it easy to rotate the pouch (per the posting on this site) but it was still too stiff.

If there was a manufacturer that could combine the best aspects of the Coloplast Sensura Mio pouch with the Hollister New Image wafer, they'd clean up!

Thanks for sharing that, Alastair! Wouldn't it be great if an "open-source" ostomy kit was available to mix and match various brands? There are some adhesive coupling 2pc systems that are compatible with each other, but the adhesive coupling (in my opinion) causes more trouble than it's supposed to solve.

@Alastair

I agree. I have been using the Sensura Mio click. They start to peel away from my skin too, so I have been using wafer extenders and that helps quite a bit. They do start to pull away too, but I have really dry skin. They do give me some extra time though. You might give then a try. I’ve used both coloplast and Hollister. I prefer the Hollister ones. 

I received the sample of this 2-piece system from Coloplast, and am kind of shocked at the amount of negatives it has.
Since it's known that all filters seem to clog up pretty fast no matter the brand, having no way to burp the bag once the filter is clogged (without adding another product like the EZ burp product) is a deal breaker.
Having the pre-filter clog up as well isn't good.
As it's been pointed out, without a "floating flange" to be able to press the bag onto, and having to press against your body hard enough to get it to click just doesn't seem safe at all. Yes, you could attach the bag before applying the flange to your body during a change, but what if you need to remove the bag for some reason after that.
Trying to rotate the bag with the lock clicked off, was very tight and felt like I would rotate/pull the flange off of me, it was so tight. The lock too, seemed very difficult to unlock. Maybe I'm doing something wrong, but was difficult for me.
The bottom velcro closure seems like the only good thing.

@Tim Thanks for sharing your experience, Tim!

What appliance did you come from before trying the 2pc Mio?  

Ditto Tim. Two wks w/ Sensura Mio. The barrier is one of the best. Unlike Hollister, it doesn't deteriorate w/wear & shower. Nice heavy pouch w/cover that is durable. I just opened the flap & raised the drain-Burp! Yes, tiny lock is awkward to manage. The elderly/arthritic will hate that.

Negatives: The filter is a loss. Pancakes like crazy(tried lubing the top). Hard to "strafe" excess poop down from top. Attaching to barrier was Impossible. No floating flange & cannot get enough pressure under to "Click". Ended up using it like a one piece & attaching beforehand. Got a little peristomal skin irritation, as not a perfect fit. The Coup de Gras. Emptying is a MESS! Wide floppy ends smear poop everywhere! Both hands, pouch, velcro & toilet seat, YUCK!
Going back to Hollister. Lighter & easy to empty. I pre cut their tiny flaps equally & very little lingering poop on the ends.

A little blood while cleaning is normal. Got into a Hollister Trial. They sent me the same products as always, but they were old. I noticed they deteriorated a bit quicker than usual. Got $100 for trying.

Bruising your stoma is BAD! I use a Stoma Guard by Stealth Belt. Fits into their belt. Sounds like you have some peristomal leakage. Try crusting.

I have found, similar to your review, amazing results re leaking with this system. My stoma is oblong/funky shaped oval, but generally I'd say it's under 40 to 45mm at its biggest point and when most swollen. I have been using the blue ones, I believe 60mm...i only had one red sample to try when I was a little less experienced at application and it leaked a bit. I can't be sure if it was user error or the ring being narrow ie less of a channel around my stoma.... Ideally the red is smaller and fits my skinny body better but I was curious if having something too close to the stoma size ie red is 50mm, if that may increase leaking... I can have liquid or very thick output that likes to pancake (directly 1 to 2 hrs after eating) so I deal with both extremes bc I between eating its semi liquid to straight water like liquid.

Is there any correlation to leaking when fitting wafer size to just beyond stoma size (esp with the plastic ring/frame as with the mio click)

For any reading I have a tiny torso, hips touch ribs... And just leaning forward for a bite of food made my wafer bend. The one piece units maybe got me a day, on a really good run I got 2 days a few times.... These mio click wafers are still comfy and flexible but have just enough frame to them to resist bending as easily as the one piece.... I had similar results with the convex one piece mio units but they were causing the efferent limb of my loop ileostomy to start to prolapse... It would shrink back down but it was a little concerning so I stopped using them. The mio click gave me the same/even better anti leak performance without the prolapsing

Also I put baby oil in a unicorn bottle I had for my vape juices and I add a small amount and I can rotate it well. I hold the base by the belt loops so it doesn't tug on the wafer and loosen and adhesive when I turn the bag sideways. I highly recommend for exclusive side sleepers! I only sleep on my left side bc of spinal issues and pain... So at night I rotate the bag to point across my belly... On my side this let's it drain straight down... Once I'm up I reposition it to point to croch area which works best for day to day and exercise, clothing fitting.

Thank in advance if anyone knows about the sizing of wafer.... And I hope any of the superfluous shizz I added helps another trying to find a way to make this work with life.... It's great to feel like you're regaining some "power" and choice in your life again and not constrained by the leaking pooh bag. Hugs to all! ❤️

Hi Kathi, thanks for the comment.

In regard to the wafer size, I find that it's best not to get too close to the last "ring" on the cutting guide on the back of the wafer. Certainly try not to cut beyond the largest cutting line. 

On the two-piece, it's hard to cut too much, since you have the plastic flange coupling acting as a barrier. Some appliances (like one-piece) make it easier to cut beyond that line, but it's not recommended.

If you look at the way this Mio wafer is designed, you'll notice a darker colored circle in the center part, and then it gets lighter on the border.

Anecdotally, in my experience the center area tends to stick better than the outer border area, so having a larger wafer can sometimes help by allowing more of that darker area to be in contact with your skin. 

Thank you so much! That's a very good point about the center sticking better. Its a very fine balance between an appliance that allows for greater freedom of movement vs one that is durable and less prone to leaks. I appreciate the thoughts! I probably with stick with the slightly bigger one since it's been working well. It's always a nail biter to take a risk on something potentially subpar when the insurance covers a set amount monthly lol.

Be well and enjoy your Thursday! 💖

My Adapt rings seem to be deteriorating/melting more quickly these days. I tried a Coloplast Brava ring, which worked well, then the company sent me some sample baseplates and pouches as well as packets of deodorizing lubricant. Last night I tried the whole shebang for the first time. The baseplate seems to work well, but the pouches they sent have the circle filter - and my goodness, I woke up smelling an odor, which seems to permeate the filter, and saw that it really pancaked, which made it difficult to empty; the lubricant (like the Adapt lubricant) didn’t seem to work at all as a deodorizer. I was not really expecting it to but had skipped my usual M9 drops just to see.

What I liked: the first barrier ring I tried didn’t deteriorate much (we’ll see if the second has when I change baseplates); the baseplate was cut to size (when I remove this I will see how it actually worked); the click feature, which made me feel more confident; the extra little piece of Velcro that makes the pouch stay tucked in; and that the cover has a viewing window of what is going on inside.

The pancaking and the odor seeping out from the circular filter are pretty bad, but I will try this again, adding M9 drops, and call Coloplast to ask if they can let me try a non-filter pouch.

Update: Took off the pouch and took a shower with the baseplate on, then found a leak under the pre-cut baseplate, removed it, skin was irritated, what a mess. Hope to try a non-filter pouch with a cut-your-own baseplate. Maybe this system just isn’t for me; I’ll find out, I guess.

Posted by: @llholiday

My Adapt rings seem to be deteriorating/melting more quickly these days.

Have you noticed any changes in the packaging or appearance? I know that Hollister has silently been making changes to a few products, or at least the packaging from what I've seen with my own supplies, but if there are any changes, it could explain the poor recent results.