PSA lowering

My PSA test over the past few years as went from being in the 1.(+) now at .40 which is right before the below normal range. I have very little drops of fluids when I climax, and serve pain as time of climaxing. I also use catheters 90% of the time. My urologist seams to just say we will monitor the condition; my question are:
Is there an issue with low PSA?
Is there an issue with drops of liquid when climaxing?
Why would I have serve pain when climaxing (yes they have checked for inflammation and infection)?
What questions should I be asking my urologist?

I think every person knows how difficult it is to talk about anything dealing with sex.
Thanks for the help.