Nephrogenic adenoma is an uncommon entity, particularly in children. This benign lesion is believed to represent urothelial transformation in response to trauma or inflammation. Current treatment is local resection with fulguration of the base of the lesion, long-term antimicrobial therapy and periodic cystoscopy. Our 2 cases support not only the urothelial transformation theory but raise the possibility that immunosuppression may be a contributing factor in these lesions.