I have a painful lump at my spermatic cord just above my testis, what is this? is it serious?

Epididymitis: A painful "lump" above the testis is usually epididymitis. This is common and can be treated with antibiotics and anti-inflammatory medications. See a physician for diagnosis and treatment.

Spermatocele or itis: Is an epididymal cyst or spermatocele if discrete cystic lump, & scrotal skin not swollen or hot, no UTI or non-painful if untouched. Could be epididymitis if very tender, scrotum is swollen & overliying skin thickened & hot, with or without UTI symptoms of urinary frequency & burning on urination. Could also be a hernia. Suggest "get thee to a urologist" or at least 1ary care physican. Good luck.

May be ...: Without detailed hx and physical with direct inspection and palpation, it's hard to give an accurate dx, but the most common possibilities are either epididymal cyts (or called spermatoceles) or post-vasectomy change. Most of times, both are virtually painless, but at times, tender to touch or palpate. More individual detail" see doc in expertise timely. Clinically, either is not serious, and...