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

Innovations in Urologic Residency Education

Posted by | Mar 2022

Wesley A. Mayer, MD, Associate Professor of Medicine, Assistant Dean of Graduate Education, and Vice Chair of Education in the Scott Department of Urology at Baylor College of Medicine in Houston, Texas, discusses innovations in urologic residency education in the face of changing technology and COVID-19. He begins with a brief history of medical training, explaining that the apprenticeship model was standard until around the start of the 20th century, when William Halstead began to develop the traditional surgical education experience featuring intense and repetitive experiences with surgical patients. Dr. Mayer then lists new challenges in modern surgical training, including work-hour restrictions, influence from other high-stakes fields, an increasingly litigious environment, rising expectations from the public, a progressive physician shortfall, and generational changes in learning style and needs. He argues that to meet these challenges, modern surgical training should: leverage simulators as well as inanimate and animate models; deconstruct complex surgeries into component skills; incorporate structured objective assessment tools; utilize concise, constructive, real-time feedback; address broader stressors impacting trainees, such as wellness and burnout; develop non-surgical skills; and innovate through servant leadership. Dr. Mayer then discusses recent innovations in open surgical training, highlighting the benefits of using cost-effective models based on cheaper materials and 3D printing rather than expensive traditional benchtop models and cadaveric simulations. He moves on to look at innovations in endoscopic surgical training and innovations in laparoscopic/robotic surgical training, emphasizing the benefits of virtual reality training models and video-based coaching. Dr. Mayer summarizes the recent experience of resident education in the Scott Department, particularly focusing on the department’s participation in a trial of SIMPL, a smartphone-based surgical skills assessment tool. He then briefly expands upon innovative feedback models and ways to manage trainee wellness and burnout. Dr. Mayer also considers the effect of COVID-19 on surgical training, observing that while the pandemic led to reduced resident work hours and increased concern that residents would not be able to meet minimum case requirements, the rise of videoconferencing allowed for the positive development of nationwide urology didactics. He closes the presentation by discussing innovative educational uses of social media and the importance of non-technical skills training.

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The Medical Assessment and Surgical Management of Adrenal Masses for the Practicing Urologist

Posted by | Feb 2022

Wesley A. Mayer, MD, Associate Professor of Medicine at Baylor College of Medicine in Houston, Texas, discusses how urologists should medically assess and surgically manage adrenal masses. He begins by briefly going over his sources, including the 2016 European Society of Endocrinology Clinical Practice Guideline, the 2011 Canadian Urology Association Guidelines, the 2009 American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Guidelines, material from UpToDate, and the work of Alexander Kutikov, MD, FACS. He highlights the fact that there is no AUA guideline on adrenal masses, as well as very little new guidance in this space. Dr. Mayer suggests that urologists should be more involved in managing adrenal masses since they are surgical experts of the retroperitoneum, familiar with the anatomy and pathophysiology of the kidneys and adrenal gland, and experts at minimally invasive surgery. He then defines the adrenal mass as a >1 cm lesion that can arise from the medulla or cortex. He explains that the majority are discovered incidentally and are called “adrenal incidentaloma,” and advances in modern imaging technology have significantly increased their prevalence. Most adrenal masses are benign lesions but some are not, and Dr. Mayer lists three important questions a urologist should ask to determine risk when confronted with a mass, including whether there are characteristics suggestive of a malignancy, whether the mass is hormonally active, and whether the patient has a history of malignancy. He then summarizes key points in how to evaluate adrenal masses radiologically and metabolically, and discusses when biopsy is necessary. Dr. Mayer follows this with an overview of surgical management, noting that laparoscopic adrenalectomy is standard of care for most masses and open adrenalectomy should be performed if adrenal cortical carcinoma is suspected. He also shows a video of an adrenalectomy for pheochromocytoma. Dr. Mayer concludes by explaining that follow-up is important since some masses will convert to being hormonally active and/or will have concerning growth characteristics.

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Endoscopic Challenges in the Renal Transplant Patient

Endoscopic Challenges in the Renal Transplant Patient

Posted by | Apr 2021

Wesley A. Mayer, MD, outlines common urologic complications of renal transplant patients and discusses surgical options and endoscopic strategies to build confidence in managing these patients. Some of the urologic complications for renal transplant patients include ureteral strictures and urolithiasis. Dr. Mayer discusses using endourologic treatment, ureteroscopy, and PCNL to treat these complications. He discusses that there are more kidney donors accepted with stones and how to select patients for these transplants. He explains that ex vivo ureteroscopy is a safe, quick, and relatively straightforward and effective management option for donor kidneys with stones. He suggests working with an endourologist in complex cases.

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Guideline-Based Approach to Metabolic Stone Management for the General Urologist

Guideline-Based Approach to Metabolic Stone Management for the General Urologist

Posted by | Feb 2021

Wesley A. Mayer, MD, Associate Professor of Medicine at Baylor College of Medicine in Houston, Texas, discusses the AUA guidelines for the medical management of kidney stones, also known as nephrolithiasis. There are 27 guidelines, fitting into the categories of evaluation, diet therapy, pharmacologic therapy, and follow-up. Dr. Mayer urges urologists to care for the whole patient, and to not just focus on the surgical issue. Nephrolithiasis is both a surgical and medical disease, making follow-up with these patients essential. For example, urologists can use a metabolic work-up to reduce the risk of future stone formation. Dr. Mayer concludes by reemphasizing that stone management often requires multiple modalities, including diet and medication, and by noting that for complex cases, urologists may want to consider referring patients to a dietician or other expert.

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