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ISLAMIC MEDICAL EDUCATION RESOURCES 04

23.1 URO-GENITAL SYSTEM, jihaaz bawli & jihaaz tanaasuli

By Professor Omar Hasan Kasule Sr.

23.1.1 DISORDERS OF THE URINARY TRACT

In urinary incontinence or hematuria, wudhu is followed immediately by salat with no delay. Suitable urinary bags should be worn to prevent soling clothes and the place of prayer. Hematuria causing anemia exempts from saum. Patients with renal failure not in coma pray as much as they can but are exempt from saum in order to control fluids and electrolytes. In urolithiasis, movements are restricted if they trigger pain and salat is delayed while patients are under sedation to control pain. Stress of hajj movements and change in meals in a hot and dry climate may trigger pain. Patients prone to stone formation have to be careful while fasting to make sure they take plenty of fluid and avoid hot environments that lead to excessive fluid loss.

 

23.1.2 DISORDERS OF THE MALE GENITAL TRACT

It is offensive for a male but not a female with no libido to marry. Lack of libido is grounds for divorce or khulu’u. In cases of impotence marriage is nullified after a grace period of 1 year. Pre-mature, delayed, or no ejaculations are not sufficient grounds for divorce. Priapism causing physical harm to the wife and should be treated before coitus. Polygyny is recommended for a male with excessive unsatisfied sexual desire. Circumcision, partial or complete excision of the prepuce, is a hygienic measure highly recommended but those who cannot be circumcised should be careful to clean properly under the prepuce during istinjah. Cases of cryptorchidism should seek counseling about fertility before marriage.

 

23.1.3 DISORDERS OF THE FEMALE GENITAL TRACT

Kindness is required for wives when they experience loss of libido, lack of sexual enjoyment, dyspareunia, and vaginismus. Lack of libido and sexual interest in a woman is not considered a barrier to marriage. In cases of prolonged menstruation or dysfunctional uterine bleeding, it suffices to pad the perineum, make wudhu, and pray immediately without waiting. Menstruation exempts from fasting and not DUB. Hormonal regulation is menstruation is allowed for hajj but not fasting of Ramadhan. Sexual relation can be undertaken in prolonged DUB if care is taken to prevent ascending infection. DUB is ignored in computation of ‘iddat in both pre-menopausal and post-menopausal women. Surgical treatment of septate or imperforate vagina should be attempted before marriage dissolution due to non-consummation. The Law treats infertility as a disease for which surgical and medical treatment must be sought. A spouse is legally liable for transmitting infection to the partner. A proper balancing of harm, dharar, and benefit, maslahat, must be considered in treating benign malignancies because of destruction of the reproductive function. Hysterectomy for uterine fibroids destroys the reproductive function and leads to psychological problems in a woman who then can no longer menstruate. The period of post-abortion bleeding is recognized as nifaas. In cases of hemostatic disorders and ecclampsia termination of the pregnancy may be the best way to save the mother’s life but it will adversely affect the fetus who may not yet be viable extra-uterine. Delivery complication may lead to difficult choices between saving one of the lives: mother or infant. The Law gives precedence to the mother.

 

23.1.4 GENDER DIFFERENTIATION AND GENDER IDENTITY

The disorders are anatomical and physiological with serious behavioral and legal implications affecting marriage, procreation, and inheritance

 

23.1.5 OBSTETRIC AND GYNECOLOGICAL DISEASES

Radical mastectomy for breast cancer has cosmetic implications that can affect marital relation through psychological effects. Ovum donation or in invitro fertilization are prohibited for anovulatory infertility.

(c) Professor Omar Hasan Kasule Sr. 2004