I am a content box for offcanvas navigation
I am a content box for offcanvas navigation
I am a content box for offcanvas navigation


Combining PDE5i for Erectile Dysfunction


Dimitris Hatzichristou

Professor of Urology
Get AccessFull Video

Rate this product!

Content: PDE5 inhibitors have been used widely for more than 25 years, both with and without prescription. We often see patients that have been using them for a long time, others that have been disappointed by their efficacy and others that have tried many different types. Clinicians often try to select the most appropriate PDE5inhibitor for their patients, but this not always straightforward. Dimitrios Hatzichristou is a Professor of Urology that has been studying the efficacy of PDE5 inhibitors for more than 25 years. Triggered by two recent publications, he talks about ways of combining PDE5is according to his research data. Can one use different types of PDE5i simultaneously and expect a better outcome compared to using one type? Is there a benefit of combining PDE5i with shockwave therapy? What can one expect from such combinations? Dimitris Hatzichristou, shares the most important finding of a systematic review of all the metanalysis that they recently published on JAMA, and also goes much beyond these recent publications to share his large clinical experience on the use of PDE5inhibitors. He explains why this topic is important, what the most important findings are, how he selects the appropriate PDE5i for each patient and his view of the best clinical approach.


*Mykoniatis I, Pyrgidis N, Sokolakis I, Ouranidis A, Sountoulides P, Haidich AB, van Renterghem K, Hatzichristodoulou G, Hatzichristou D. Assessment of Combination Therapies vs Monotherapy for Erectile Dysfunction: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021 Feb 1;4(2):e2036337

*Mykoniatis I, Pyrgidis N, Zilotis F, Kapoteli P, Fournaraki A, Kalyvianakis D, Hatzichristou D. The Effect of Combination Treatment With Low-Intensity Shockwave Therapy and Tadalafil on Mild and Mild-To-Moderate Erectile Dysfunction: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. J Sex Med. 2022 Jan;19(1):106-115.

Produced in 2022

Dimitris Hatzichristou

Professor of Urology

Dimitris Hatzichristou, MD, PhD, FECSM, is Professor of Urology of Aristotle University of Thessaloniki, Greece. He is also President of the Institute for the Study of Urological Diseases (ISUD), a non profit organization, dedicated to education and awareness on Urological conditions.


He received his MD and Ph.D. degrees and completed his training in Urology at Aristotle University in Thessaloniki, Greece. Then, he completed a 2-year fellowship in Andrology at Boston University, Boston, USA and then he worked as visiting scholar (prostate diseases) for a year at Stanford University, California, USA. Prof. Hatzichristou organized and chaired the foundation meeting of the European Society for Sexual Medicine in 1995, served as Secretary General (1995-97), President Elect (1999-2001) and President (2001-2004) of ESSM. He has been also a faculty member of the European School of Urology (ESU), founding member of the European Society of Andrological Urology (ESAU), member of the Executive Committee of the International Society for Sexual Medicine (ISSM), the EAU Committee for the guidelines on erectile dysfunction (2004-2014) and co-chairman of the Committee on “Diagnostics and Scales in Sexual Medicine” of the International Consultation in Sexual Medicine since 2004. Dr Hatzichristou has served as Review and Educational Editor for the Journal of Sexual Medicine and the Journal for Impotence Research, Editorial board member for Urologia Internationalis and the Journal for Sexual and Reproductive Medicine, and reviewer in major scientific journals, including European Urology, Journal of Urology, International British Journal of Urology. He has been invited speaker in more than 250 international meetings and teaching courses worldwide. He has authored 25 book chapters in international books, as well as more than 120 review and peer-review papers with more than 15000 citations (h-factor=51).

Related Content

The Clinical Management of Shame (Part 1 & 2)

Male ejaculation and orgasm: What a sexologist needs to know

Relationships, Attachment and Sexual Functioning

"This isn't an affair!?"

Michael Perelman's Fundamental Contribution to Sex Therapy

Couple Facing Infertility

Regenerative Therapies for Erectile Dysfunction

Couple Facing Premature Ejaculation

Gender Affirming Surgery: What a Sexologist Needs to Know

Spreading the message of Ellen Laan: In pursuit of sexual pleasure

Explaining the Sexual Tipping Point: A Guide to Enhance Your Sex Therapy Practice (Part 1 & 2)

Mindfulness for Sex Therapy: Clinical Applications (Part 1 & 2)

Gender Affirming Surgery: Then What?

Combining PDE5i for Erectile Dysfunction

Single Man with Performance Anxiety

Sexual Therapy and Borderline Personality Disorder

Facing Premature Ovarian Insufficiency

Young Man with Psychogenic Erectile Dysfunction

Implications of an Affair for Couple Sex Therapy

Stanley Althof's Fundamental Contribution to Sex Therapy

Congenital Penile Curvature: What a Sexologist Needs to Know

Table for More than Two: How to Manage Consensual Non-monogamy in Couple Sex Therapy (Part 1 & 2)

Gain Confidence in Handling patients' Secrets and Lies in Couple Sex Therapy (Part 1 & 2)

Male Sexual Pain: Assessment and Multidisciplinary Approach (Part 1 & 2)

Treating body dysmorphic disorders (Part 1 & 2)

A non pathologizing approach in the assessment of gender incongruence and gender affirming treatment (Part 1 & 2)

Treating Compulsive Sexual Behaviors: Beyond the Addiction Model (Part 1 & 2)

Treating Psychogenic Erectile Dysfunction advanced (Part 1 & 2)

Healing Sexual Trauma: a step by step approach for therapists (Part 1 & 2)

Sexual History Taking for Male Sexual Dysfunctions (Part 1 & 2)

Can they Succeed where we Fail: All about Surrogate Partner Therapy (Part 1 & 2)

Prostate Cancer: Management of Sexual Needs Starting from the Diagnosis (Part 1 & 2)

Making and Expecting a Baby: How to Prepare a Couple for the New Sexual Challenges (Part 1 & 2)

An Integrated Model to Assess and Treat Compulsive Sexual Behavior Disorder (Part 1 & 2)

Management of Psychopharmachology for Sexual Function

Sexuality after Prostate Cancer Treatment

News on Surgical Treatments for Sexual Problems

Advances in Male Sexual Dysfunctions

Advances in Female Sexual Dysfunctions

From Literature to Clinical Practice: Which hints should sexologists take from evidence based medicine

Psychogenic Aspects of Male Sexual Dysfunctions

What Makes a Treatment Plan Successful in Female Genital Pain

Clinical Management of Sexual Difficulties in Psychiatric Patients

Ejaculatory Disorders

Psychogenic Aspects of Erectile Dysfunction

Biological Aspects of Erectile Dysfunction