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When symptoms do appear, men typically describe one or more of the following: A dull, dragging, or aching feeling in the scrotum that worsens after long hours of standing, exercise, or by the end of the day A soft, lumpy texture above the testicle that some men describe as feeling like a bag of worms or strands of spaghetti Visible swelling on one side of the scrotum, almost always the left side Shrinkage of the affected testicle (testicular atrophy) over time Difficulty conceiving with a partner after a year of regular, unprotected intercourse Pain typically eases when lying down because gravity no longer works against the failed valves, allowing blood to drain from the pooled veins

Biochem Soc Trans 1996