Do I need surgery with phimosis?

Circumcision is best. & most reliable way to take care of problem phimosis. Prepucioplasty or dorsal slit is also surgical, however the foreskin can be preserved. Twice daily application of steroid cream to the tight are of skin works in some cases, but works best in children & has an up to 50% recurrence rate. Hence most urologists recommend circumcision.
No. Depending on how tight the phimosis, one may need to have surgery. If the phimosis is not very tight, then conservative management with topical creams and gentle retraction may all that is needed. If these measures fails, then surgery is the next step is surgery for a circumcision.