title: Nephrogenic adenoma in the augmented bladder.
abstract: OBJECTIVE
  Nephrogenic adenoma is an uncommon, benign urothelial lesion. Risk factors for nephrogenic adenoma include trauma, chronic inflammation, immunosuppression and radiation. We characterized nephrogenic adenoma in the pediatric augmented bladder.
  
  
  METHODS
  We reviewed the records of patients diagnosed with nephrogenic adenoma from January 2000 to March 2010. Those with prior bladder augmentation were studied further. Data were retrospectively obtained on pathological characteristics, cystoscopic findings, recurrence patterns and presentation.
  
  
  RESULTS
  Ten patients with ileal bladder augmentation and nephrogenic adenoma were identified. The underlying pathological condition was myelodysplasia in 7 patients, sacral agenesis in 2 and bladder exstrophy in 1. Concomitant procedures were a continent channel in 9 patients, ureteroneocystostomy in 5 and bladder neck reconstruction in 7. Mean time to the discovery of nephrogenic adenoma was 9.2 years. During that time a total of 221 surveillance cystoscopies were performed in patients with bladder augmentation. The diagnosis was made by surveillance cystoscopy in 7 cases, at surgery for bladder stone in 2 and by cystoscopy for urinary incontinence in 1. Nephrogenic adenoma was identified along the floor in 5 cases, near the channel entrance in 3 and adjacent to the enteric anastomosis in 2. Six patients returned for surveillance with recurrence identified in 2. The longest recurrence free interval was 27 months.
  
  
  CONCLUSIONS
  Nephrogenic adenoma is not uncommon in the augmented bladder and it is often asymptomatic. The lesions tend to develop at sites that may be prone to chronic catheterization injury. Recurrent lesions are not unusual.
authors.affiliation: Division of Pediatric Urology and Pathology, Riley Hospital for Children, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: Ethan I
authors.initials: EI
authors.lastname: Franke
authors.forename: Rosalia
authors.initials: R
authors.lastname: Misseri
authors.forename: Mark P
authors.initials: MP
authors.lastname: Cain
authors.forename: Martin
authors.initials: M
authors.lastname: Kaefer
authors.forename: Kirstan K
authors.initials: KK
authors.lastname: Meldrum
authors.forename: Rong
authors.initials: R
authors.lastname: Fan
authors.forename: Richard C
authors.initials: RC
authors.lastname: Rink
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000175:diagnosis / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*; D019459:Urothelium / Q000473:pathology