How can you tell the difference between congenital phimosis and adult-onset phimosis? Also, does having phimosis mean someone is impotent? And is there a way to treat congenital phimosis without needing surgery, maybe using something like betamethasone cream?

Congenital phimosis is present from birth, where the foreskin cannot be retracted due to a tight opening, while phimosis in adults often develops due to scarring or infection. Phimosis is not considered impotence, as it primarily affects the foreskin's ability to retract, not erectile function. Betamethasone cream can be effective in mild cases of congenital phimosis by reducing inflammation and allowing easier retraction, but surgery may still be required for more severe cases.