A thick and hairy bladder wall indicates an obstruction and inflammation of the bladder. In this case, routine urinalysis and ultrasound of the bladder are recommended to assess for bladder outlet obstruction and inflammation in the urine. If there is inflammation, it is recommended to drink more water, urinate more often, and take broad-spectrum antimicrobials, most commonly levofloxacin 0.2g/dose, twice a day, orally for 5-7 days to control inflammation. If there is bladder outlet obstruction or urethral stricture, the outlet obstruction should be addressed and alpha blockers can be taken to improve dyspareunia. Male patients may have prostate enlargement and female patients may have bladder neck sclerosis.