Incidence of Epididymal Cysts
Epididymal cysts occur in approximately 16-34% of males, with incidence strongly age-dependent, doubling after age 14-15 and reaching 33.8% in males older than 14 years. 1
Age-Related Prevalence
- Epididymal cysts are uncommon in young children but become significantly more prevalent during and after puberty, with the highest rates observed in adolescents and young adults aged 14-18 years 1
- In a retrospective ultrasound study of 363 boys and adolescents, 16.2% overall had epididymal cysts, but this increased dramatically to 33.8% in boys older than 14 years 1
- The frequency of epididymal cysts doubles after age 14-15 years, typically appearing in adolescence or early adulthood 2
- Most epididymal cysts occur in men aged 20-40 years old 3
Clinical Context and Detection
- Approximately 50% of epididymal cysts are discovered incidentally during scrotal ultrasound performed for other reasons, while the other 50% present with scrotal mass and/or pain 1, 4
- Among infertile men undergoing scrotal ultrasound evaluation, epididymal cysts are commonly identified as incidental findings 5
- Epididymal cysts are frequently associated with other scrotal pathology, particularly varicocele (46% of cases in one series) and history of epididymo-orchitis (26% of cases) 4
Natural History
- Approximately 50% of epididymal cysts involute spontaneously within an average of 17 months, supporting conservative management for asymptomatic cases 2
- In conservatively managed patients, cysts resolved in 61% (17 of 28 boys), while the remaining 39% remained stable in size and asymptomatic during follow-up periods ranging from 11 months to 5 years 1