Foley Catheter and Islamic Rulings on Purification: A Clinical-Fiqh Review and Patient-Community Survey

Foley and suprapubic catheters are commonly used for postoperative urinary drainage and intake-output monitoring. For practicing Muslims, continuous urinary drainage raises important concerns regarding ritual purification (wuḍū), prayer validity, and recitation of the Qur'an. Our objective was to review Islamic jurisprudential (fiqh) rulings related to catheterized patients and to assess awareness, concerns, and acceptance of these rulings among patients and the wider community, with the aim of providing practical clinical guidance.

This hospital based mixed-method study comprised: (1) a clinical-fiqh review of classical and contemporary Islamic rulings regarding purification in patients with continuous urinary drainage, and (2) a structured questionnaire-based survey conducted among catheterized patients and community participants. The study was conducted jointly at the Department of Urology, Pakistan Railways General Hospital, Rawalpindi, and the Department of Islamic Studies, Riphah International University, Islamabad, from January to June 2024. A bilingual (English-Urdu) questionnaire was administered before and after counseling. This assessment was designed to evaluate the clinical impact of a structured, faith-sensitive counseling intervention delivered as part of routine patient care, rather than to conduct a standalone knowledge, attitude, or practice survey.

A total of 500 participants were enrolled, including 250 catheterized patients and 250 community members. Baseline awareness of Islamic rulings related to catheterization was 22%, which increased to 91% following counseling (p < 0.001). Most participants reported fear of missing prayers or reciting the Qur'an incorrectly. Jurisprudential review demonstrated consensus that catheterized patients are classified as ma'dhūr (legally excused) and may perform prayer according to prescribed concessions.

Catheterized Muslim patients should be counseled in accordance with established Islamic rulings on purification to prevent unnecessary spiritual distress. Integrating clinical care with fiqh-based guidance supports holistic patient well-being without compromising medical management.