Had one since at least 10th grade in high school which was picked up by the old turn your head and cough physical before basketball season. I’m 39 and as you noted it seems the biggest issue is infertility, which did affect me. I vaguely recall mild discomfort/heaviness through some of high school but nothing of note since then, which has included 20 years of triathlon/cycling - a lot of which was prior to the wide use of split rail saddles. Not sure if suggested treatment changes if it’s developed later in life, but I revisited all of this around 2014 when wife and I were trying to have kids and was told if no pain then no treatment necessary.