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Abstract:The generation and processes of wadi flash floods are very complex and are not well understood. In this paper, we investigate the relationship between variations in geomorphometric and rainfall characteristics and the responses of wadi flash floods. An integrated approach was developed based on geomorphometric analysis and hydrological modeling. The Wadi Qena, which is located in the Eastern Desert of Egypt, was selected to validate the developed approach and was divided into 14 sub-basins with areas ranging from 315 to 1488 km 2 . The distributed Hydrological River Basin Environment Assessment Model (Hydro-BEAM) was used to obtain a good representation of the spatial variability of the rainfall and geomorphology in the basin. Thirty-eight geomorphometric parameters representing the topographic, scale, shape and drainage characteristics of the basins were considered and extracted using geographic information system (GIS) techniques. A series of flash flood events from 1994, 2010, 2013, and 2014, in addition to synthetic virtual storms with different durations and intensities, were selected for the application of this study. The results exhibit strong correlations between scale and topographic parameters and the hydrological indices of the wadi flash floods, while the shape and drainage network metrics have smaller impacts. The total rainfall amount and duration significantly impact the relationship between the hydrologic response of the wadi and its geomorphometry. For most of the parameters, we found that the impact of the wadi geomorphometry on the hydrologic response increases with increasing rainfall intensity.

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Introduction Vaginal foreign bodies (FBs) are a rare cause of vesicovaginal, rectovaginal, or urethrovaginal fistulae. Aim The aim of this study was to describe a rare case of vesicovaginal fistula (VVF) and obstructive uropathy and to review the literature. Methods A case is presented. A comprehensive review of the literature was performed (1948–2013). Results A 38-year-old woman presenting with sepsis, obstructive uropathy, and severe emaciation was found to have a sex toy retained in her vagina for 10 years. This had caused a VVF and bilateral hydroureteronephrosis. Bilateral nephrostomies were inserted and she underwent cystoscopy and examination under anesthesia (EUA) with retrieval of FB. A left ureteric stricture was demonstrated. Transabdominal VVF repair with omental flap and left ureteric re-implantation was performed. The VVF recurred, which was successfully re-repaired transvaginally. Seventy-six full text articles were reviewed. There were no previously published cases of VVF following vaginal sex toy insertion. There are four cases of obstructive uropathy secondary to a vaginal FB in the literature: three pessaries and one plastic cap. There are 44 cases of VVF secondary to FB: 22 plastic caps (typically from aerosol bottles, inserted for masturbation or contraception) and 5 pessaries. At least nine were in girls aged ≤18 years. Average presentation is 15 months (range 2 months to 35 years) after FB insertion. Most cases were managed with surgical repair; predominantly transvaginal. Conclusions This case describes an extremely rare but potentially life-threatening case of obstructive uropathy caused by a chronically retained sex toy, and adds to the list of potentially rare causes of a VVF and obstructive uropathy. We advocate urinary diversion, staged removal of FB, upper urinary tract imaging, and EUA with VVF repair and/or ureteric reimplantation if required. Transvaginal is the preferred access for FB-associated VVF repair without concomitant ureteric reimplantation.