Double J (DJ) ureteral stenting is widely used to manage ureteral obstruction and maintain urinary drainage. In cases of severe obstruction, long-segment fibrosis, or ureteral wall compromise, a single stent may be insufficient. Dual ureteral stenting — placing two DJ stents in the same ureter — has been proposed to optimize urine flow and prevent persistent hydronephrosis. This study aims to introduce and validate the DUBAI Score (Dual Ureteral Stenting-Based Assessment Index) as an objective system to identify patients who may benefit from dual DJ stenting.

This retrospective study included 20 patients with complex ureteral obstruction treated at a tertiary urology center. The DUBAI Score incorporates five clinical parameters: degree of obstruction, ureteral wall damage, length of blockage, success of single-stent attempts, and imaging findings of hydronephrosis. Each parameter is scored as 1 (mild), 2 (moderate), or 3 (severe). A cumulative score of 7 or higher indicates the need for dual stenting. Patient outcomes, including relief of obstruction, complication rates, symptom resolution, and need for reintervention, were analyzed.

Patients with a DUBAI Score of 7 or higher who underwent dual stenting demonstrated superior renal drainage, faster resolution of hydronephrosis and flank pain, and improved renal function compared to single-stented patients. The complication rate was comparable between dual and single stenting. Dual stenting significantly reduced the need for repeat interventions and shortened hospital stays.

The DUBAI Score offers a standardized and practical approach for selecting patients who may benefit from dual ureteral stenting. In our cohort, dual stenting was associated with better clinical outcomes without an increased complication burden. The scoring system may reduce unnecessary interventions and optimize patient management.

The DUBAI Score provides an objective tool for identifying candidates for dual DJ stenting in severe ureteral obstruction cases. This approach optimizes patient outcomes and minimizes repeat procedures. Further prospective studies with larger cohorts are recommended to validate the clinical utility and generalizability of the DUBAI Score.