I'm thinking the abnormal DRE, coupled with the low %fPSA, indicates biopsy. Not something any of us want to do, but as has already been expressed, when it's time, it's time.
Let's hope it's negative and they find another cause of your symptoms. Good luck.
Dx Age 64 Nov 2014, 4.3
BX 3 of 12 cores positive original pathologyG6, G6, G8 (3+5)
downgraded to 3+3=6 by Dr Epstein, JH
RALP with Dr Ash Tewari Jan 6, 2015
Post surgical pathology – G7 (3+4), ECE, Margins, LN, SV all negative
PSA @ 6 weeks 2/15, .<02, 4/15 <.02 7/15 <.02, 10/15 0.00 (new lab) , 1/16, 0.00
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