(From sinus, and hernia). A hernia of the urinary bladder protruding into the vagina. Hence called cystocele vaginalis, or clytro-cele. A patient had been for many years liable to violent hysteric affections, which at last were succeeded by a dry, convulsive cough. When this cough disappeared, she was seized with a suppression of urine, together with great pain and tenseness in the abdomen. When other remedies had failed, the catheter was employed; but with difficulty introduced. This suppression returned very frequently, was always preceded by the convulsive cough, and sometimes attended even with convulsions, which commonly ended in faintings. The obstruction which occurred to the introduction of the catheter seemed to proceed from a considerable weight and pain which the patient complained of in the fore part of the genitals, and which was always most severe when the suppression of urine was not considerable. On examining the parts, the hypogastric region was tense and painful, but there was no considerable tumour perceivable, as there usually is, in the under part of the belly, when the urine has Seen long suppressed; but, upon introducing the finger into the vagina, while the suppression continued, a large tumour was discovered, which occupied the whole cavity of the vagina. In this swelling a fluctuation was perceived, but no urine could be evacuated by compressing it, unless the catheter was at the same time introduced, and then a plentiful evacuation ensued; though, even in this manner, the contents of the swelling could not be entirely discharged, unless the compression was continued. When the urine was entirely evacuated, the catheter could be easily introduced; the tumour disappeared; the superior part of the vagina felt lax and flaccid; and the finger could be easily pushed up to the mouth of the uterus, till the tumour began again to increase, by the urine collecting in the bladder. Then the former symptoms returned; and were relieved, as before, by the catheter. The urine, which at first was of a natural appearance, after the disorder had subsisted for some time, became less pure, and seemed to contain a number of small membranous filaments, as if the internal coat of the bladder had been eroded. From this time the sensibility of the bladder became so much increased, that it was found necessary to introduce the catheter much more frequently than before. On considering the case, it appeared that a pessary, properly adapted for the support of the relaxed parts, would, in this case, probably be the most effectual remedy; and an instrument of that kind being procured, and so constructed as not to prevent the discharge of the menstrual flux, it was introduced; and being continued for several years, till the parts had again recovered their tone, a complete cure was at length obtained. The pessary was then no longer necessary, and the patient discharged her urine with perfect ease. See Edin. Med. Comment. vol. v. p. 257. Sauvages' Nosol. Meth. vol. i. p. 216.