What is the ruling on istinja' after urination, and is it done with water and soap or with water only?
Istinja' from urine and stool is obligatory. It is permissible to perform istinja' with water alone, or with toilet paper alone. The best way is with toilet paper then water. If one wishes to suffice with one of them, then water is better. And Allah the Almighty knows best.
Should a prayer performer who forgets to offer the middle Tashahod (saying ash-hadu anala ilaha ila-alah) offer Sujood As-Sahw (prostration of forgetfulness)?
He/she should offer two prostrations of forgetfulness at the end of the prayer. And Allah Knows Best.
What is the ruling on speaking while relieving oneself?
It is disliked for one relieving himself to speak while doing so, except out of necessity. And Allah the Almighty knows best.
Which is better during the day in Ramadan: reciting the Quran or performing voluntary prayers?
A Muslim should establish a daily schedule for reciting the Quran in Ramadan.
Once they have completed their daily portion (known as a wird or hizb), they can engage in other acts of worship, including voluntary prayers (nawafil). Prayer itself is called "Quran", because a significant part of it involves reciting the Quran.
Allah says: "BE CONSTANT in [thy] prayer from the time when the sun has passed its zenith till the darkness of night, and [be ever mindful of its] recitation at dawn: for, behold, the recitation [of prayer] at dawn is indeed witnessed [by all that is holy]." [Al-Isra`/78]