Unclear, but...: Real reason is unclear, but fact/experience tells it occurs in men with inborn poor fixation to the sac so to form so-called bell-clapper deformity of testis. While its peak age around 15-19, it may occur at any age. Based the timing of its occurrence, it has been construed that hyperactivity of cremasteric muscles of spermatic cord may be prone to incite its twisting.
Answered 1/30/2015
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