Strengths and Limitations
Like all retrospective studies, our study is limited by its nature and the limitations inherent in such a design. Besides, there were fewer patients in the ORC group compared with nonusers. Although residents noted the electronic medical records as detailed as possible, we might have underestimated the adhesion rates because assessment and description of adhesion is subjective and there has not been a validated adhesion scoring system to be used for the two procedures. Our study has several strengths. The inclusion criteria were designed to minimize the effect of confounding factors as possible such as previous pelvic operations on the outcomes, and the CSs were performed by three physicians in the same hospital with profound experience and similar surgical techniques.