Combining PDE5i for Erectile Dysfunction
10m
Dimitris Hatzichristou
Professor of Urology
Trailer
Get AccessFull VideoContent: 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
Lecturer
Dr. Dimitris Hatzichristou serves as Professor of Urology at the Aristotle University of Thessaloniki and as President of the Institute for the Study of Urological Diseases (ISUD). After earning his MD and PhD at Aristotle University, Dr. Hatzichristou completed a three-year fellowship in Sexual Medicine at Boston University and served as a Visiting Scholar in Prostate Diseases at Stanford University.
He is a founder and former Secretary General and President of the European Society for Sexual Medicine (ESSM). He has served as a member of the Executive Committee of the International Society for Sexual Medicine (ISSM), for a decade on the Guideline Committee of the European Association of Urology (EAU), and for 20 years as a Committee Chair of the International Consultation in Sexual Medicine. Through his leadership within ESSM, he initiated the provess for the recognition of Sexual Medicine as a European subspecialty by UEMS, and the establishment of the ESSM School.
Dr. Hatzichristou has authored more than 150 peer-reviewed publications and 32 book chapters, accumulating more than 22,000 citations and an h-index of 60. In 2026 he received the European Society for Sexual Medicine (ESSM) Career Award, honoring a senior scientist whose work has made outstanding contributions to the advancement of sexual medicine. Hiw research interests included pathophysiology, pharmacotherapy and surgery of erectile dysfunction. He has also made important contributions to the understanding and management of Peyronie’s disease. He is consistently ranked among the Stanford University Top 2% of Scientists worldwide, placing within the top 0.5% in Medicine and among the top 0.1% of researchers in erectile dysfunction.
Guided by a strong translational vision, his research over the last 15 years has focused on regenerative therapies aimed at restoring tissue structure and function rather than merely alleviating symptoms. He contributed to establishing clinical protocols for low-intensity shockwave therapy, conducted the first double-blind clinical trial evaluating platelet-rich plasma (PRP) for erectile dysfunction, and is currently leading the first international clinical study investigating the therapeutic use of autologous exosomes.
An internationally sought-after speaker and educator, Dr. Hatzichristou has delivered more than 300 invited lectures and workshops worldwide. His work bridges fundamental science, clinical innovation, and translational medicine, contributing to the evolution of sexual medicine from a symptom-oriented field toward disease-modifying and regenerative therapeutic strategies.