What is the management of nephrogenic adenoma (benign renal tumor) in the bladder?

From the Research

Nephrogenic adenoma of the bladder is best managed with complete transurethral resection (TUR) as the primary treatment approach, as supported by the most recent study 1. This benign lesion, which represents a metaplastic response to bladder injury, should be completely excised to confirm diagnosis and prevent recurrence. The management of nephrogenic adenoma can be broken down into several key points:

• Complete transurethral resection (TUR) is the primary treatment approach
• Regular cystoscopic surveillance is recommended every 3-6 months initially, then annually if no recurrence is noted, due to the recurrence rate of approximately 30-90% 2, 3
• No specific medical therapy is required for nephrogenic adenoma, though addressing underlying causes such as chronic inflammation, infection, or trauma to the urothelium is essential for preventing recurrence
• If recurrences are frequent or symptomatic, more aggressive approaches may include intravesical treatments with agents like mitomycin C or BCG, though evidence for these is limited 2
• Patients should be counseled that while nephrogenic adenoma is benign and not premalignant, its presentation can mimic bladder cancer, necessitating proper histopathological evaluation 1
• Management should also include treatment of any underlying conditions like urinary tract infections, bladder stones, or catheter-related trauma that may have contributed to the development of this reactive lesion 4, 5

Given the possibility of recurrence and the rare possibility of malignant transformation, long-term follow-up is essential, as highlighted in the most recent study 1. The clinical significance of nephrogenic adenoma of the urinary bladder lies in its potential to mimic malignant tumors of the urinary tract, making proper histopathological evaluation crucial 1. Overall, the management of nephrogenic adenoma of the bladder should prioritize complete excision, regular surveillance, and treatment of underlying conditions to prevent recurrence and ensure the best possible outcomes for patients.