ObjectivesThis study evaluated the symptoms, results of pelvic examination, and laboratory and radiologic findings of patients with 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. Overall extrinsic and intrinsic involvement of the urinary tract occurred in 40 (16%) of 249 patients with advanced pelvic endometriosis. Pelvic pain was the most common presenting symptom, experienced by 25 (63%) patients.ResultsA pelvic mass was the most common finding on pelvic examination (80%). Pelvic computed tomography or ultrasonography revealed a pelvic mass in 18 (78%) of 23 patients who underwent such evaluation. Intravenous pyelography revealed ureteral obstruction in 15 (55%) of 27 patients with ureteral involvement. Microscopic hematuria existed in 4 (11%) patients. The association of cyclic pain with gross hematuria was not noted.ConclusionsThe clinical symptoms, results of pelvic examination, and computed tomography or ultrasonography findings were not different from those seen in patients who had endometriosis without urinary tract involvement as reported in the literature. Negative results of intravenous pyelography do not eliminate the possibility of nonobstructive ureteral involvement by endometriosis.