@wever59 Questions should be about BPH and treatments for it if it is causing urinary issues. Also ED if that is an issue. With a negative biopsy and PSA/free PSA both in gray zones there is not much to do with cancer until there is further evidence. May want to increase PSA testing to every 6 months vs every year ... that is about all they can do unless your PSA continues to increase. One measure used for cancer is PSA doubling time. Divide your current PSA by 2 and look for the previous test that was about that number. Probably many years. It is usually months with significant prostate cancer.

The kicker is that even if one of your biopsy cores had been positive for cancer with 3+3 Gleason your urologist would likely recommend active surveillance until it got worse. Would ask if you were ready for ED and incontinence because a significant number of patients have those side effects from treatment. Almost everyone has dry orgasms. So have to balance treatment of a slow growing cancer against quality of life going forward. AS is required to make sure it is caught early if/when growth speeds up.

@wever59 With the size of your prostate (pretty large) your PSA of 5 isn't remarkable unless there are other indications of PC. More likely BPH issues.