What is the ruling on istibra' and how is it performed?
Istibra' (cleansing from urine) is recommended. It is for a person to ensure that nothing remains of urine in its passage before performing istinja'. Its method is: to clear the throat (or cough slightly), shake the penis (meaning to pass fingers along it to expel any remaining urine if needed), and walk a few steps to the extent that one thinks nothing of urine remains if walking is needed. Each person knows his own nature best. The preferred opinion is that this differs among people. The objective is for one to think that nothing remains in the urinary passage that he fears will exit later. And Allah the Almighty knows best.
Does using a gargling medicine break the fast?
If the medicine reaches the body cavity (jauf), the fast is invalidated. However, if it does not enter the body cavity, the fast remains valid.
Therefore, it is advisable to avoid using it during the day in Ramadan.
Does vomiting during the day in Ramadan break the fast?
Intentional vomiting is one of the nullifiers of fasting; whoever vomits deliberately breaks their fast.
However, if vomiting occurs involuntarily, the fast remains valid as long as nothing returns to the body cavity (jauf). If anything is swallowed back, the fast is invalidated.
The Prophet ﷺ said: "Whoever is overcome by vomiting does not have to make up the fast, but whoever induces vomiting deliberately must make it up." [Narrated by Abu Dawood and At-Tirmidhi]
What is the ruling on performing istinja' with perfumed tissues or a tissue moistened with water?
Performing istinja' with perfumed or moistened tissues is not sufficient if they are not dry, due to the moisture on them reaching the impurity, which increases its spread rather than reducing it. Then, to remove the impurity, one must use pure water. And Allah the Almighty knows best.