Bridging the Gap in Cryptorchidism Care: Knowledge and Practices of Primary Care Physicians in Tunisia

Background Abnormal testicular migration (ATM), or cryptorchidism, is a common congenital condition in boys, with early detection and timely surgical referral crucial to prevent long-term complications such as infertility and testicular cancer. Primary care physicians (PCPs) play a key role in identifying and managing ATM, but their knowledge and practices in Tunisia remain poorly understood. Methods This national cross-sectional survey, conducted from December 2022 to June 2023, assessed the knowledge, attitudes, and practices of 504 PCPs involved in pediatric care across Tunisia using a structured electronic questionnaire. Sociodemographic data, knowledge of ATM, and clinical practices were collected, and associations between variables were analyzed using chi-square tests (p < 0.05). Results Although nearly all participants reported familiarity with ATM, only 30.2% correctly defined the condition. Knowledge of optimal timing for surgical correction was limited, with fewer than 10% recognizing that surgery before one year of age aligns with international guidelines. Misconceptions persisted regarding spontaneous testicular descent and long-term risks. Routine testicular examinations were inconsistently performed, and ultrasounds were frequently requested despite guideline recommendations. Most physicians referred patients to pediatric surgeons, yet referral timing varied. Higher knowledge scores were significantly associated with pediatric specialization, longer clinical experience, urban practice, and routine genital examination. Conclusion : In conclusion, while awareness of ATM is widespread among Tunisian PCPs, gaps remain in detailed knowledge and adherence to evidence-based practices. Strengthening continuing medical education and improving collaboration with pediatric surgical services could enhance early detection and standardize management, ultimately reducing the risk of adverse outcomes for affected children.