Ultrasound reveals hydrocele, epididymal cysts and 2 varicocele on the left side. Should I be concerned? I am 39 years.

"Scrotal cocktail" Fortunately all3 conditions are benign. Not to worry. Only need treatment if scrotal problems are interfering with your life, ie pain, discomfort , infertility or hydrocele is too large for you to want to live with it forever. Good urologic surgeon could certainly correct all 3 with one operation. Could have just a hydrocelectomy, + varicocelectomy if ur infertile. Most epudidymal cysts can b left.
Do you hurt? Varicoceles are common on the left side in males and are due to reflux of blood from a blood vessel that connects to your left kidney vein. These can be treated with surgery or with embolization. See a urologist or an interventional radiologist if you are having symptoms of pain or infertility. If there are varicoceles on both sides, it could be more serious. Epididymal cysts are benign and common.