I cannot give you medical advice but since your MRI only hinted at one PiRad4 - which could be cancerous and treated focally - might it not be better to pursue whatever is causing this repeated infection?
The recent Cipro dose may have blunted the attack, but you’ve been down this road before.
Cipro is a broad spectrum antibiotic so they like to use it when they don’t know the exact cause of the infection; this way they can kill everything….hopefully! Carpet bombing doesn’t guarantee you’ll kill everything, right? In fact, some broad spectrum antibiotics are much less effective than those targeting a SPECIFIC bacterium. Until they find out what that is, they’re shooting blind.
Here’s an idea and I would run it by your urologist AND infectious disease specialist. If you do a biopsy some of that tissue - or perhaps an extra core so as not to confuse things - could be cultured.
It’s a simple matter of putting some of your infected prostate tissue in a culture dish with growth medium to see what grows out.
Also, the pathologist examining your biopsy slides would need a heads up that he might be seeing bacteria, mold or yeast in your specimen; or at least to be on the lookout for it.
Yes, it will take coordination on your part and cooperation on theirs but it’s certainly worth a try
Phil