Strict Standards: call_user_func_array() expects parameter 1 to be a valid callback, non-static method JModuleHelper::renderModule() should not be called statically in /home/vasginek/public_html/libraries/joomla/cache/handler/callback.php on line 99

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 143

Strict Standards: Non-static method JRequest::getCmd() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 144

Strict Standards: Non-static method JRequest::getVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 255

Strict Standards: Non-static method JRequest::_cleanVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 134

Strict Standards: Non-static method JFilterInput::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 577

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JFactory::getLanguage() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 188

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRequest::getBool() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 219

Strict Standards: Non-static method JRequest::getVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 217

Strict Standards: Non-static method JRequest::_cleanVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 151

Strict Standards: Non-static method JFilterInput::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 577

Strict Standards: Non-static method JDispatcher::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 511

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/advancedmodules.php on line 132
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Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JLoader::load() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 161

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 138

Strict Standards: Non-static method JModuleHelper::getLayoutPath() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/mod_mainmenu.php on line 42

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 266

Strict Standards: Non-static method JDispatcher::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 511

Strict Standards: Non-static method modMainMenuHelper::render() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/tmpl/default.php on line 82

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 345

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getUser() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 346

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JFactory::getSession() should not be called statically in /home/vasginek/public_html/libraries/joomla/factory.php on line 163

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JComponentHelper::getComponent() should not be called statically in /home/vasginek/public_html/components/com_contact/router.php on line 23

Strict Standards: Non-static method JComponentHelper::_load() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/component/helper.php on line 39

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_contact/router.php on line 24

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

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BMI Kalkulator

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Kalkulator kalorija

Starost(god)
Visina(cm)
Težina(kg)
Pol
Aktivnost

Kalkulator trudnoce

Unesite datum poslednjeg ciklusa:
Miomi materice
Ocena korisnika: / 86
LošeNajbolje 
Napisao dr Petar Čanković   
Kao što je u kardiologiji najpoznatija bolest - infarkt, tako je u ginekologiji - miom.
Miomi su benigni tumori materice i najčešći su tumori male karlice, koji se kod žena starijih od 35 godina javljaju u skoro 20% slučajeva. Uglavnom ne daju simptome, mada mogu izazvati obilnije menstruacije, iregularna krvarenja ili sterilitet, bez obzira na njihovu lokalizaciju i veličinu. Osim što mogu biti uzročnici spontanih pobačaja, prevremenih porođaja, porođaja sa nepravilnim tokom, ili mogu sprečiti njegovo ostvarivanje, (myoma previum-prednjačeći miom). Tokom razvoja trudnoće, kod mioma se može razviti upadljiva nekroza, (raspadanje tkiva), ili miom može izazvati neadekvatnu poziciju ploda, zaostajanje posteljice, kao i posleporođajno krvarenje zbog nastale mlitavosti tumurozne materice.

 

Sve ovo ukazuje na to da svaki miom treba lečiti, posebno ako nije ostvarena reproduktivna funkcija.

Lokalizacija mioma, bilo jednog ili više njih u meterici, skoro da je presudni faktor postojećeg inferteliteta, (nemogućnost oplodnje). Postavljen odmah ispod endometrijuma, (sluzokože materice), submukozni miom onemogućava usađivanje oplođene jajne ćelije ili remeti odgovarajuću ishranu embriona, uslovljavajući tako njegov rani gubitak. Postojanje hroničnog endometritisa je često u delu endometrijuma koji prepokriva miom, koji takođe može remetiti normalno usađivanje ili ishranu embriona. Lokalizacija mioma u blizini roga materice narušava funkciju materičnojajovodne jedinice ili pak dovodi do pritiskanja i zatvaranja jajovoda. Smešten u oblim materičnim vezama, miom menja uobičajni anatomski odnos između jajovoda i jajnika, sprečavajući tako prihvatanje jajne ćelije. Lokalizacija mioma iznad grlića materice menja njegovu poziciju u odnosu na vaginu, sprečavajući tako prirodnu oplodnju.

Nažalost, hirurški način lečenja mioma još uvek nema svoju medikamentoznu alternativu. Široka primena analoga rilizing hormona, (hormoni koji utiču na rad hormonske osovine i polne organe), pokazala je dobar ali veoma kratkotrajan medikamentozni učinak. Obzirom da su miomi estrogen zavisni tumori, primena analoga rilizing hormona, posle obaranja nivoa estrogena u organizmu na kastracioni nivo, dovešće prvo do zaustavljanja rasta mioma, a zatim i do smanjenja njegovog volumena, (davanjem a-GnRH 10-12 nedelja dovodi do smanjenja volumena mioma za trećinu i daljom primenom neće bitnije uticati na njegovu veličinu). Sa prestankom njihovog davanja, odnosno sa uspostavljanjem funkcije jajnika i porastom estrogena u organizmu, miomi će ponovo pokazati tendenciju rasta, (ponekad i ubrzanog), a što govori o nedostatku ove terapije. Međutim, ova terapija ima svoje mesto u pripremi bolesnice za operaciju mioma.

Zbog toga, izvođenje miomektomije, (odstranjenje mioma - laparotomijom ili laparoskopskim putem), kod pacijentkinja sa infertelitetom, povećava značaj pitanja kolika je povezanost izmedju mioma i oplodnje, odnosno mogućnosti iznošenja trudnoće do kraja. Mnogi miomi ne utiču na fertilnost ili na porođaj, a rezultati posle učinjene miomektomije, govore često o minimalnom povećanju fertilnosti. Istovremeno, treba naglasiti da uklanjanje mioma u veoma visokom procentu ostavlja postoperativne adhezije, (priraslice), koje kasnije zahtevaju sprovođenje posebne procedure lečenja.

Zbog svega iznetog, glavne indikacije za miomektomiju su:

  • sekundarni sterilitet sa anamnestičkim podatkom o spontanom pobačaju,
  • priprema za sprovođenje vantelesne oplodnje,
  • postojeće hipermenoreje, (obilna menstrualna krvarenja), koje vode u anemiju i
  • postojanje tumora velikih dimenzija.
 
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