Epididymal cysts in children: a systematic review and meta-analysis of treatment approaches and clinical outcomes.
Ugo Maria Pierucci, Rianne J M Lammers, Yesica Quiroz Madarriaga et al.
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In 30 seconds
This PRISMA-compliant systematic review and meta-analysis synthesised observational evidence on epididymal cysts in boys younger than 18 years. Nine retrospective studies included 492 patients; no controlled comparative studies were identified. Cysts were generally benign, often detected incidentally, and commonly managed conservatively. Complete spontaneous regression occurred in 12.2% (95% CI 8.3-16.1%), while 7.4% (95% CI 3.1-11.7%) required surgery. Postoperative complications were uncommon, and the available evidence did not establish that cysts predispose to testicular torsion.
Key findings
- Bilateral cysts occurred in 8% (95% CI 7-9%) of patients.
- Complete spontaneous regression occurred in 12.2% (95% CI 8.3-16.1%; I 2 = 88.1%).
- Surgery was required in 7.4% (95% CI 3.1-11.7%; I 2 = 94.7%) of children.
- Postoperative complications occurred in 3.4% (95% CI 1.1-5.6%; I 2 = 0%); evidence did not establish a link with testicular torsion.
Why it matters
The review characterises paediatric epididymal cysts as benign lesions with a generally favourable natural history, while quantifying how often regression, surgery, and postoperative complications were reported. These estimates can inform discussions about expected outcomes and the uncertainty in the evidence, particularly because the included studies were observational and did not directly compare management strategies.
What to keep in mind
All nine included studies were retrospective, and no controlled comparative studies were identified. Estimates for regression and surgery showed substantial heterogeneity.