Many small boys have a tight foreskin (phimosis). This condition may cause the foreskin to become swollen when the child urinates. Phimosis does not require surgery. An inflamed foreskin also tends to heal by itself as the child grows.
However, balanitis xerotica obliterans, which causes a previously loose foreskin to become tight, needs to be treated with circumcision. A tight foreskin in an adolescent boy may also need to be treated with preputioplasty or, in some cases, circumcision.