Though there are several causes of retention of urine and constipation for a few days in many diseases of anal canal and rectum; inspissated fecal mass impaction is the most common cause in absence of any organic disease. There may be distension of abdomen, vomiting and pain abdomen in addition to constipation and retention of urine.
Many times an attending physician fails to diagnose the condition and cause because he/she fails to put a finger in the anal canal. It is obvious to miss the cause and at the first sight it appears to be a difficult case.
In old age the colonic movement may not be so active to expel the hard mass. Hard mass forms due to fewer intakes of water and less fiber in diet, and postponing the defecation.
It can be quickly diagnosed after a per rectal digital examination and a simple warm water enema is sufficient to evacuate the mass. In very late cases the fecal mass has to be manually removed.