Wesley A. Mayer, MD

Wesley A. Mayer, MD

Baylor College of Medicine

Houston, Texas

Wesley A. Mayer, MD, is an associate professor of urology, the vice chair for education of the Scott Department of Urology, and an assistant dean of graduate medical education at Baylor College of Medicine in Houston, Texas. Dr. Mayer earned his medical degree from Baylor College of Medicine, graduating with highest honors. He completed his internship in general surgery and his urology residency at the University of Pennsylvania in Philadelphia, Pennsylvania. Dr. Mayer is fellowship-trained in advanced robotic, laparoscopic, and endoscopic surgery in Baylor College of Medicine’s Scott Department of Urology.

Dr. Mayer specializes in advanced minimally invasive surgical treatments for urologic diseases including robotic, laparoscopic (including single-site), endourologic, and percutaneous surgery. He has a special interest in kidney cancer, kidney stones, upper urinary tract reconstruction, adrenal masses, and transplant urology. He has also published research and has been invited to speak on these topics at several national and international conferences. Dr. Mayer has been repeatedly selected as a “Top Urologist in Houston, Texas” in The Leading Physicians of the World and a “Top Doc” in Houstonia Magazine.

Dr. Mayer is an accomplished educator. He received prestigious Norton Rose Fulbright Faculty Excellence Awards for educational leadership, as well as for teaching and evaluation. He was nominated for the 2020 Distinguished Faculty Award at Baylor College of Medicine and for a national teaching award from the Resident and Fellows Committee of the American Urological Association (AUA). Dr. Mayer has been an invited faculty member for several national educational courses, including the AUA’s Annual Oral Board Examination Review course and the AUA’s Mentored Laparoscopy course. Dr. Mayer served on the Accreditation Council for Graduate Medical Education’s (ACGME) Urology Milestones 2.0 Working Group, which created competency-based developmental outcome goals used by all accredited urology residency programs in the United States. He has participated in a number of task forces for the Society of Academic Urologists and for the ACGME’s Urology Standing Panel for Accreditation Appeals. Dr. Mayer has published widely on innovations in surgical education, co-authoring over 30 publications on cutting-edge surgical technology and techniques, and he has been an invited panelist at numerous national and international conferences concerning a variety of topics in education.

Talks by Wesley A. Mayer, MD

PCNL Challenges: How to Keep the Train on the Rails

PCNL Challenges: How to Keep the Train on the Rails

Posted by | Jan 2025

Wesley A. Mayer, MD, offers a comprehensive discussion on optimizing percutaneous nephrolithotomy (PCNL), focusing on minimizing complications, strategic planning, and adaptive surgical techniques.

In this 20-minute presentation, Dr. Mayer reviews indications for PCNL with updates on guidelines. He stresses the importance of individualized treatment decisions. Mini PCNL is emphasized for challenging lower pole stones, and for smaller stones, balancing efficiency and patient outcomes.

Dr. Mayer stresses preoperative preparation, underscoring the value of detailed imaging. The choice of access (prone vs. supine) is tailored based on patient anatomy, stone location, and procedural requirements. The importance of a flexible and adaptive approach is stressed, with practical examples illustrating the decision-making process when encountering complications.

Lastly, Dr. Mayer underscores the importance of knowing when to continue versus when to safely abort a procedure, reflecting on the need for prudent judgment to optimize patient safety and surgical outcomes.

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Tales from the GME Crypt: Managing Challenging (and Scary) Residency Dilemmas

Tales from the GME Crypt: Managing Challenging (and Scary) Residency Dilemmas

Posted by | Nov 2024

Wesley A. Mayer, MD, focuses on effectively managing challenges faced in residency programs, emphasizing remediation strategies over punitive measures. Drawing from his experience as a program director and assistant dean of Graduate Medical Education (GME), Dr. Mayer addresses dilemmas common in residency, outlining a practical approach to navigating issues such as technical skill deficiencies, communication breakdowns, and personal crises among trainees.

In this 20-minute presentation, Dr. Mayer differentiates remediation from probation, advocating for remediation as a supportive, non-reportable process for skill enhancement. The importance of recognizing warning signs, such as poor performance or behavioral changes, is highlighted, stressing early intervention and the role of the GME office in offering support and resources.

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Programmatic and Institutional Paradigms for Building and Sustaining a Successful Wellness Program

Programmatic and Institutional Paradigms for Building and Sustaining a Successful Wellness Program

Posted by | Jan 2024

Wesley A. Mayer, MD, presents actionable programmatic and institutional paradigms for building and sustaining a successful wellness program within one’s practice or institution while avoiding burnout. He begins by defining the elements of burnout, their impact on institution-wide productivity, and the high rate of burnout in the field of Urology.

Dr. Mayer then turns to the ACGME’s well-being requirements for Urology programs. While these requirements were intended to preserve the wellness of faculty and residents in theory, Dr. Mayer highlights that the lack of specific goals in institutional wellness programs can lead to “hedonistic” initiatives and inconsistent results.

Dr. Mayer then turns to how his own institution, the Scott Department of Urology at Baylor Medical School, sought to consistently address burnout. He outlines the paradigm created by his department, the tools they used to evaluate the success of their efforts, and the results.

He concludes by enumerating the steps other institutions can take to implement similar anti-burnout programs. He provides suggestions for national-level interventions, and reinforces the need for intentionality behind wellness programs.

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Mini Percutaneous Nephrolithotomy: Should We Find Space in Our Endourologic Toolbox?

Mini Percutaneous Nephrolithotomy: Should We Find Space in Our Endourologic Toolbox?

Posted by | Dec 2023

Wesley A. Mayer, MD, discusses miniaturized percutaneous nephrolithotomy (mPCNL). He explains procedures for dilating the tract, pointing out many sizes of metal dilators and sheaths available to surgeons. He covers the vortex effect, stent placement, and nerve block. Dr. Mayer then summarizes the American Urological Association (AUA)/ Endourological Society Guideline from 2016 for the surgical management of renal stones.

Dr. Mayer then compares mPCNL to standard PCNL (sPCNL) and retrograde ureteroscopy and proposes a framework for operative decision-making. Dr. Mayer examines mPCNL vs. sPCNL, whereby studies showed no difference in volume of damaged parenchyma or in systemic response to surgery-induced tissue trauma. He shares another study that showed higher average intrapelvic pressures using mPCNL, more time spent in the “danger zone” and greater dissemination of bacteria into other organs.

Dr. Mayer describes challenges in interpreting the literature, such as what qualifies as mPCNL, outcome metrics, follow up, imaging methods used, and what constitutes “stone-free.” He shares data illustrating that stone-free rates between mPCNL and sPCNL are comparable. The data also shows that transfusion risk favored mPCNL, as did length of hospital stay. However, operative time favored sPCNL. Dr. Mayer shares a retrospective review that indicated for larger stones, sPCNL was superior.

He compares mPCNL with ureteroscopy, finding that, while length of stay is longer with mPCNL, stone-free rates are similar. One comparison examined ultra-mini PCNL (umPCNL) and ureteroscopy, and indicated that umPCNL had favorable operative time, cost, complications, and stone-free rates. Dr. Mayer outlines the drawbacks of ureteroscopy before concluding by emphasizing that size matters and practitioners should choose wisely among various treatment procedures, including mPCNL and umPCNL.

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