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The urinary tract is the second extragenital system most frequently affected by deep infiltrating endometriosis (DIE). The incidence of urinary tract endometriosis ranges from 1% to 5.5% of all women affected by endometriosis, reaching 16.4–52.6% in patients with DIE. The most common type of ureteral endometriosis (80%) is extrinsic, which involves the adventitia. Intrinsic involvement affects the muscularis propria, lamina propria, or ureteral lumen. Treatment goals for ureteral endometriosis include: relieving the ureteral obstruction, preserving renal function, and preventing disease relapse. Medical therapy is contraindicated in ureteral obstruction due to the risk of progressive ureteral stenosis and hydronephrosis, as well as loss of renal function.