slope, kinking, and IPP buckling were correlated to vaginal insertion strength, horizontal load strength, and prosthesis rigidity. Conclusions: Although all the implants reached the axial rigidity for vaginal intromission, our results demonstrate in a cadaveric model that RTEs negatively affect the rigidity due to RTE kink formation when paired with larger (>20cm) implants while in the case of shorter im- plants the kink formation occurred in the IPPs This should be consid- ered as a guide during RTE selection for a patient undergoing penile prosthesis. Disclosure: Work supported by industry: yes, by Coloplast. 030 POSTOPERATIVE PENILE PROSTHESIS PAIN: IS IT WORSE IN DIABETIC PATIENTS? Apoj, M. 1 ; Biebel, M. 1 ; Rajender, A. 1 ; Rodriguez, D. 1 ; Didi, T. 1 ; Gross, M. 2 ; Munarriz, R. 1 1 Boston University School of Medicine; 2 Dartmouth-Hitchcock Medical Center Introduction: Inflatable penile prosthesis (IPP) surgery is an effective, safe and satisfactory treatment option for medication-refractory erectile dysfunction. Postoperative complications include infection, mechanical failure, erosion, and pain 1 . Current literature suggests the need for a better approach to postoperative pain management after IPP surgery 2 . Further- more, targeted pain management strategies for diabetic patients have been suggested in the non-urologic literature, as several clinical studies have demonstrated that postoperative pain is different in diabetic and non-dia- betic patients 3 . Objective: The purpose of this study is to determine if there is a difference in postoperative pain after IPP placement in diabetics. Methods: This is a single-institution retrospective review of 173 primary penoscrotal three-piece IPP prosthesis cases performed between 2014 and 2017. The main outcome measure was the number of 30-day postoperative emergency room and unplanned clinic visits specifically for significant pain. T-test was used for mean assessment and chi-square analysis was used for proportion assessment. P values <0.05 were considered statistically signifi- cant. The top HgbA1C quartile (with values greater than or equal to 8) was compared to the other HgbA1C quartiles, for a total of 30 (23%) and 98 (77%) patients, respectively. Results: Diabetes was present in 92 (54.4%) patients and 96% of these had HgbA1C greater than 8. Significant postoperative pain was more common in patients with HgbA1C greater than 8 (41% versus 13%, p ¼ 0.047) and resulted in more unplanned 30-day post-operative emergency room and/or clinic visits (27% versus 11%, p ¼ 0.042). Patients with HgbA1C greater than 8 with significant postoperative pain were more likely to be managed with a combination of opiates and gabapentin (30% versus 14%, p ¼ 0.05). There were no statistical differences in age in diabetics and non-diabetics (mean 59 versus 61, p¼ 0.193). Hispanic and African-American patients represented 87% of the poorly controlled di- abetics compared to only 13% of white patients (p <0.001). Poorly controlled diabetics had more medical comorbidities (p < 0.001). There were no differences in intra- or postoperative surgical complications in either group. Conclusions: Significant pain after IPP surgery was statistically higher in diabetics with HgbA1C greater than 8, which resulted in more unplanned 30-day post-operative emergency room and/or clinic visits. Approximately 90% of diabetics with HgbA1C greater than 8 were African-American and Hispanic patients. Patients with significant postoperative pain were managed with a combination of opioids and gabapentin. Future studies are required to optimize pain management in diabetics following IPP placement. Disclosure: Work supported by industry: no. 031 “SUPER-USERS” OF HEALTHCARE: IDENTIFYING DRIVERS OF EXTREME COSTS FOLLOWING PENILE PROSTHESIS PLACEMENT Bajic, P. 1 ; Kirshenbaum, E. 1 ; Doshi, C. 1 ; Nelson, M. 1 ; Hehemann, M. 1 ; Bresler, L. 1 ; Farooq, A. 1 1 Loyola University Medical Center Introduction: The top five percent of patients ranked by their healthcare expenditures account for more than half of total healthcare spending in the US. 1 In post-surgical patients, prolonged length of stay may contribute to this imbalance. Objectives: We aimed to identify and characterize “Super-users” of post- operative care in patients undergoing penile prosthesis placement. Methods: The Healthcare Cost and Utilization Project State Inpatient Data- base and State Ambulatory Surgery Database for the states of California and Florida were analyzed for years 2007-2011 and 2009-2014, respectively. The database was queried using ICD-9-CM codes to identify patients who under- went inflatable and malleable penile prosthesis placement. Super-users were defined as patients with a postoperative length of stay (LOS) in the top fifth percentile of patients undergoing penile prosthesis placement. Super-users were compared to non-Super-users to determine differences in demographics, comorbidities, and clinical characteristics. Multivariable analysis was utilized to identify independent risk factors for classification as a Super-user. Results: 18,346 patients met inclusion criteria, of which 774 patients were identified as Super-users. Mean age for Super-users was 63.8 years (SD 11.2) vs 66 years (SD 9.3) for non-Super-users. Mean LOS was 5 days (SD 3.5) for Super-users vs 0.65 days (SD 0.6) for non-Super-users. On multivariate analysis, Super-users were also more likely to have congestive heart failure (CHF, OR 2.76, 95%CI¼1.72-4.44, p<0.01), peripheral vascular disease (PVD, OR¼2.59, 95%CI¼1.16-2.90, p¼0.01) and chronic obstructive pulmonary disease (COPD, OR¼1.76,95%CI¼1.35-2.31, p<0.01), and to be younger than age 65 (OR 1.89, 95%CI¼1.50-2.36, p<0.01). Super-users were more likely to be African-American (OR 1.53, 95%CI¼1.11-2.04, p<0.01) and to have Medicare (OR¼1.70, 95%CI¼1.32-2.20, p<0.01) or Medicaid (OR 2.65, 95%CI¼1.29-5.46, p<0.01). Super-user status was not significantly associated with history of myocardial infarction, diabetes or paraplegia/quadri- plegia. There were no statistically significant differences noted in median household income between Super-users and non-Super-users. Conclusions: Certain characteristics - namely comorbidities including CHF, PVD and COPD, age less than 65 years, African American race, and Medicare/Medicaid insurance status - are associated with prolonged utili- zation of inpatient care following penile prosthesis placement, representing a disproportionate cost burden on the healthcare system. Urologists must make a systematic effort to identify these patients at higher risk for prolonged postoperative hospitalization and work diligently to optimize their preop- erative health status and postoperative course. Disclosure: Work supported by industry: no. 032 PENILE PROSTHESIS IMPLEMENTATION WHILE ON ANTICOAGULANT THERAPY: A RETROSPECTIVE STUDY Suarez-Sarmiento, A. 1 ; Perito, P. 1 ; Brennan, M. 1 ; Suarez-Sarmiento, A. Sr. 2 1 Nova Southeastern University; 2 Coral Gables Hospital Introduction: There are limited studies that look at how a subset of patients undergoing Inflatable Penile Prosthesis (IPP) implantation while on antico- agulant therapy fair post-operatively. IPP is commonly indicated for patients who suffer from atherosclerotic cardiovascular disease (ASCVD), yet some patients cannot temporarily discontinue their anticoagulants for surgery. J Sex Med 2019;16:S1eS143 19th Annual Fall Scientific Meeting of SMSNA S15