Extracorporeal shock wave therapy as a treatment option for persistent clitoral priapism: a case report

Introduction Clitoral priapism is persistent clitoral engorgement without sexual stimulation. Presentation is sparse, and therefore limited treatment options have been investigated.Aim We present a case report of a 34-year-old female presenting with persistent nonischemic clitoral priapism 5 years after aggressive clitoral stimulation.Methods Patient underwent six weekly Li-ESWT sessions at frequency 4 Hz, energy 0.11 mJ for 2000 shocks per session. Assessment included physical examination of clitoral glans engorgement and retraction, global response assessment (GRA) score, need for topical phenylephrine, and ability to achieve orgasm.Results At the end of the therapy, examination revealed complete resolution of priapism with a normal-appearing clitoris fully retracted behind the clitoral hood. The patient reported no longer requiring topical phenylephrine, a significant improvement in GRA, and the ability to achieve orgasm.Conclusion We present a case of nonischemic clitoral priapism resolved with Li-ESWT. More investigation regarding the utilization of Li-ESWT in the treatment of clitoral priapism is highly encouraged.