MSM vs. 6.4% HSM, p<.0001). In terms of treatment choices, HSM were more likely to undergo surgery (57.5% vs. 33%, p<.01), MSM were more likely to opt for radiation (47.6% vs. 14.9%, p<.05) and both groups were equally likely to choose active surveillance (14.9% vs. 16.7%). CONCLUSIONS: Our study shows no differences in what men with PCa find to be important when choosing PCa treatment by sexual orientation. No differences were seen perceptions or bother associated with common side effects of treatment. Despite this, more MSM appear to be choosing radiation therapy over surgery. A majority of MSM felt that there is a dearth of information on the impact of PCa treatment on their quality of life (QoL). Together, this highlights the need to offer MSM more information on side effect profiles of different PCa treatments with data on how each type of treatment impacts QoL, so that all men may make an informed decision when choosing treatment. Source of Funding: none PD40-10 THE FRAGILITY INDEX OF RANDOMIZED CONTROLLED TRIALS IN THE FIELD OF UROLOGICAL ONCOLOGY- A SYSTEMIC REVIEW Leon Chertin, Amnon Zisman, Miki Haifler*, Zerifin, Israel INTRODUCTION AND OBJECTIVE: RCT's provide high quality evidence upon which clinical guidelines are based. The use of p values to estimate statistical significance of findings is subject to significant control. In order to assess the robustness of RCTs a novel metric known as the fragility index (FI) has been developed. The FI is defined as the minimum number of events in a trial who must “shift” from the inter- vention to the control group so that the trial statistical result becomes non-significant. We previously reported the fragility in the field of urological oncology. Our aim is to evaluate the fragility in urological oncological RCTs following a systemic review. METHODS: The systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta- analysis (PRISMA). All RCTs with 2 arms and at least one binary outcome in 5 major urologic journals were identified in MEDLINE and EMBASE databases from 2016-2019. Two authors collected data including journal name, publication year, outcome, number of randomized patients, number of events and total patients in control and intervention arm, number of patients lost to follow-up, type of outcome (primary/secondary), p value. The risk of bias was calculated with Cochrane risk-of-bias tool. Correlation between FI, FQ and sample size, p value was examined with Spearman's correlation coefficient. Kruskal-Wallis test was used to examine the distribution of FI or FQ across categorical variables. All analyses were performed using R software. RESULTS: 40 studies met our inclusion criteria and 81 primary dichotomous outcomes were assessed. The median sample size and p value of RCTs were 199 (IQR 113,620) and 0.4 (IQR 0.05,0.61) respectively. The primary outcome was found to be statistically signifi- cant in 29/81 of RCT (36%).The median FI for the included 40 trials was 4 cases (IQR 3,7). The median FI for the primary and secondary out- comes was 5 (IQR 3,8) and 3 (IQR 3,6) respectively (p[0.2). In 24/40 cases (61.7%) the FI was larger than the total number of patients lost to follow up. There was a modest correlation between the fragility index and the sample size (ms 0.50, p<0.01). No correlation was found be- tween the fragility index the p value, ROB groups, study positivity, type of outcome and number of patients lost to follow up. CONCLUSIONS: The results of urological oncological RCTs are sometimes fragile and depend on few events. Considering reporting the fragility index alongside p values may better utilize the results published in RCTs in the field of urological oncology. Source of Funding: No Funding PD40-11 URINARY INCONTINENCE CARE FOR OLDER ADULTS: DIFFERENCE OR DISPARITY? Claire S. Burton*, Los Angeles, CA; Jennifer Tran, Mount Pleasant, MI; Gabriela Gonzalez, Catherine Bresee, Eunice Choi, Victoria Scott, A. Lenore Ackerman, Karyn S. Eilber, Jennifer T. Anger, Los Angeles, CA INTRODUCTION AND OBJECTIVE: Urinary incontinence (UI) has a significant burden on health care costs, particularly among the elderly. Assessing Care of Vulnerable Elders-2 (ACOVE-2) found that overall quality of care for vulnerable elders is inadequate. We sought to evaluate the care surrounding UI provided by primary care providers (PCPs) prior to referral to a specialist, and to determine whether UI is treated differently in elderly (75) vs younger (<75) female patients. METHODS: A sample of 247 women consecutively referred for new or worsening bothersome UI to a single-center FPMRS group practice between March 2017 and May 2018 was identified. Using a set of 12 previously developed Quality of Care Indicators (QIs), we measured the care provided by PCPs in the 12-month period prior to the first visit with an FPMRS specialist. The QIs for UI have been previously validated and include elements from the patient history, physical examination, urinalysis, recommended behavioral interventions, and pharmacologic treatment. RESULTS: For women  75 years of age, PCPs were less likely to take a focused history differentiating between stress and urge incontinence (55% vs 77%, p<0.05) or do a pelvic exam (26% vs 50%, p<0.01) when compared to their younger counterparts. Yet providers were more likely to take a history of prior pharmaceutical treatment (28% vs 10%, p<0.01) and obtain a urinalysis or urine culture (74% vs 57%, p<0.05) for older women. Rates of management initiation were low in both groups, with only 30% of PCPs offering behavioral man- agement (Table). CONCLUSIONS: We found generally low rates of QI compli- ance by PCPs, with older female patients receiving significantly worse care. Low rates of pelvic exams may be due to the fact that women over 75 no longer require routine pelvic exams per the USPSTF recom- mendations. On the other hand, urinalyses were more frequently ob- tained, possibly due to an increased incidence in this age group. Improvement of UI care at the primary care level for older female pa- tients could significantly reduce healthcare costs and improve practical interventions aimed at improving care for geriatric conditions, including UI. Source of Funding: 1R56DK117261-01 PD40-12 THE BURDEN OF PATIENT COMMUNICATION OUTSIDE THE EXAM ROOM IN AN INFERTILITY PRACTICE Jagan K. Kansal*, John Doolittle, Peter N. Dietrich, Vimal Gunasekaran, Zachary J. Prebay, Robert Medairos, Jay I. Sandlow, Milwaukee, WI INTRODUCTION AND OBJECTIVE: Physician burnout has been attributed to an increase in administrative tasks. Patient questions Vol. 203, No. 4S, Supplement, Sunday, May 17, 2020 THE JOURNAL OF UROLOGY Ò e819 Copyright © 2020 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.