Hello 
* As per my surgical experience, in the majority of the causes the bladder wall thickening of the moderate amount is a sequence of 
urinary tract infection.
* In some cases, the extensive wall thickness can be part of distal obstruction (as stone or 
prostate at age of 75) or bladder pathology itself.
* If there are doubtful areas of architecture, the 
urologist usually take the tissue sampling for 
biopsy (after consent of the patient only) and send to the lab for testing of the specimen.
* So far as surgery is concerned, the bladder wall thickness per se is not an indication of surgery.
* Primary goal is to treat the cause underlying and observe the condition over a period of time.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Bhagyesh V. Patel, General Surgeon