Hi,Dear,Thanks for your query to HCM.
Dear I read your query and reviewed it with context to your query facts.
Based on the facts of your query, you seem to suffer from-
Varicolcele on right side.The Niacin in cigarretes creates Vasodialation effect from PGE2 and PGI2 on vessels smooth muscles.
This causes more retention and flow throught the
Varicocele of the right cord and
testicular pain.Waking up causes pain as you rise up causing more retention of blood by gravity,which leads to more testicular pain.Stretch receptors in the tissue cause pain in the
spermatic cord and the testes.
The
smoking stopping has reduced this blood flow retention caused from Niacin effect.
This is how your right testes was paining.Do Color Doppler dual image Scan with USG study of the right Spermatic Cord and the testes.This test would fix the cause of this scrotal pain.
Second opinion from Surgeon would rule out or confirm the chances of Varicocele.
Hope this would help you to plan further treatment with your family and specialist doctors there.
Welcome for any further query in this regard.
Good Day!!
Dr.Savaskar M.N.
Senior Surgical Specialist
M.S.Genl-CVTS