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Lecture by Professor Omar Hasan Kasule Sr. for Year 2 Semester 1 PPSD session on Thursday 26th October 2006
URINARY INCONTINENCE
In urinary incontinence ablution is followed immediately by prayer with no delay. Suitable urinary bags should be worn to prevent soling clothes and the place of prayer.
Patients with urinary catheters wash and pray as usual even if the catheter is discharging urine. The should pray immediately after ablution.
FECAL INCONTINENCE
A situation of continuous diarrhea makes it difficult to maintain a state of ablution or to pray in congregation. Ablution is made immediately before the prayer. The prayer is continued uninterrupted even if diarrhea continues provided it is not too much to soil the clothes and place of prayer. If it is too much the prayer can be interrupted until the diarrhea subsides.
When an episode of diarrhea is impending, prayer is terminated immediately and at any stage and is resumed after defecation and a new ablution.
If the sick passes urine, feces, or flatus during prayer, he leaves to cleanse himself and returns either to complete the interrupted prayer or to restart from the beginning
In cases of anal incontinence, ablution is made immediately before each prayer.
STOMATA
A Stoma is a surgically created artificial opening from the alimentary tract, the respiratory tract, or the urinary tract. It may open internally or externally through the skin. It may be temporary as in tracheostomy, esophagostomy, gastrostomy, jejunosotomy, and cecostomy. It may be permanent as in ileostomy and colostomy. All types of ostomy require careful cleaning to avoid infection.
Ileostomies are usually constructed following proctocolectomy. They discharge small amounts of liquids continuously. They do not need irrigation but an appliance must be worn all the time.
Colostomies, the commonest form of ostomy, may be sigmoid or transverse. The sigmoid colostomy discharges solid stool on an average once a day and a pattern similar to normal defecation may develop. An appliance is not needed but a pouch must be worn for reassurance. Irrigation is achieved by use of a catheter. A transverse colostomy discharges liquid foul-smelling stool and is best avoided.
The colostomy site is kept as clean as possible all the time. Ablution is made immediately before prayer. Prayer is continued even if the colostomy continues discharging.
FISTULAE:
Bladder fistulae may join the vagina (vesico-vaginal fistula) or the colon (vesico-intestinal fistula). They usually follow trauma, infection, or irradiation. Rarely intestinal fistulae may discharge to the outside. Urethral fistulae may open into the vagina (urethro-vaginal), the rectum (urethro-rectal) or the skin (urethro-cutaneous).
For purposes of prayer fistulae are treated like incontinence either of urine or of feces.