A controlled evacuation ostomy appliance comprises a collection pouch, and an urging device for applying a sealing force through the pouch wall to seal the stoma. The pouch wall may seal directly against the stoma, or the pouch may have an internal sealing member that is pressed by the pouch wall against the stoma. The urging device may provide an adjustable sealing force. The pouch may be disposable. The urging device may be reusable with a replacement pouch.
