Tight foreskin may be due Balanitis Xerotica Obliterans (BXO) which may required circumcision.
Balanitis Xerotica Obliterans (BXO) is a penile skin condition which affects the foreskin, It may also affect the rounded head of the penis (called the ‘glans penis’) and, less commonly, the urethra (the tube which carries the urine from the bladder out of the body).
In BXO there is long term (chronic) inflammation of the glans penis; referred to as ‘balanitis’. Patches (called lesions) appear on the affected skin which have an abnormally dry appearance (referred to as ‘xerotica’) and are seen as white, thickened plaques. Lesions start in the foreskin but then can extend to the surface of the skin on the glans penis causing the involved areas of skin to fuse together. As a result, the foreskin can become firmly adhered to the glans so retracting the foreskin (pulling it back) becomes difficult or impossible. This is called phimosis. Issues or concerns passing urine, painful erection and tight foreskin are the commonest problems that a adult with BXO is presented to a urologist.