ObjectivesThis study evaluated the complications and results of surgical therapy for endometriosis of the urinary tract over a 25-year period.Materials and MethodsThe records of 40 patients with urinary tract involvement by endometriosis were reviewed. Long-term follow-up data were obtained from the medical records, from the patient, or from other physicians. The bladder was involved in 4 patients, the ureter(s) in 33, and both in 3. Surgical therapy included partial bladder resection in 4 patients, ureterol-ysis in 21, and segmental ureteral resection in 15.ResultsThe cure rate at a mean follow-up of 74 months (range, 14–240) was 97.3%. Ure-terolysis and ureteral resection were equally effective in relieving ureteral obstruction. No patients experienced recurrence that involved the urinary tract. One patient had a recurrence that consisted of an endometrioma involving the rectovaginal septum.ConclusionsSurgical therapy for endometriosis of the urinary tract provided an excellent long-term cure rate, and most patients had resolution of symptoms.