Your PSA does seem to be pretty high since you double it if you’re on finasteride, Which makes it close to eight.

One thing you don’t mention, is the size of your prostate. Had a friend with a huge prostate, his PSA was always around 50 never found anything with a biopsy he died of something else.

You could get a PSE test to see if it shows that Prostate cancer was found in your body, But the purpose of that test is to decide whether or not you need a biopsy and you already had one or two or three.

Lots of people with BPH have a large prostate so find out what the size of yours is and maybe that will give you some answers.