Re: High PSA
Usually they try a second antibiotic like Bactrim for about 6 weeks. Prostatitis is notoriously hard to treat. The reason I think many biopsies are unnecessary is because they usually will find something, something that if left alone might not ever be a problem. Therefore, they may lead to unnecessary anguish and treatments. For that reason, I always tell my friends in my support group to definitively rule out prostatitis (with a long course of antibiotics) and BPH (with finasteride) before taking the next step. It usually is a slippery slope.
Also, keep in mind that biopsies are only a sample from a few places (usually 12) in the prostate, and can easily miss cancers when they are there.
There are many new blood and urine tests they can do now that do a better job of finding cancer than biopsies do. These tests include % free PSA, [-2] proPSA, PCA3 and T2-ERG. What those tests can't do is give you a Gleason score (a tissue analysis). BTW, you may want to tell the doctor to send the biopsy specimens to Bostwick, Epstein, or another lab that specializes in prostate tissue -- it makes a difference who reads it.
If you're going ahead with the biopsy, make sure he's taking antibiotics -- the rectum is full of bacteria and poking holes from there into the prostate can cause prostatitis (this happened to me).
Let us know how it turns out.