Response to "Routine evaluation of vesicle-ureteric reflux in children with anorectal malformation does not reduce the rate of urinary tract infection"

We thank Middleton T, et al, for their thoughtful comments on our publication regarding the use of routine micturating cystourethrogram (MCUG) in children with anorectal malformations (ARM). We reported that an abnormal renal ultrasound scan was the only statistically significant predictor of urinary tract infection (UTI) in children with anorectal malformation, and that having a routine MCUG did not reduce this UTI risk, despite a high proportion of patients having previously undiagnosed vesicoureteric reflux (VUR), and these patients subsequently receiving antibiotic prophylaxis.