Editor—Dr Nicholl raises some pertinent points in his letter1 regarding our paper.2 The nub of the matter is whether asymptomatic vesico-ureteric reflux (VUR), detected as a result of antenatal ultrasound findings is clinically important or not. The answer to this question is not yet known and will require a trial that looks at what, if any, difference treatment makes to outcome, as judged by the development of renal scars.

Until this …