My Brother Has An Enlarged Prostate Which Is Hard. His

my brother has an enlarged prostate which is hard. His urinary bladder is enlarged as well. He has sensitivity when his penis touches his pants or anything against it. He was given CIPRO which improved his urinating several times at night and it improved greatly, but he felt that he could have used more antibiotics to get rid of this infection, but physician didn't. He states that physician wants to perform biopsy through rectum to obtain biopsy, but risky chance of severe infection that may cause hospitalization. Is there anything else that can be performed to rule out CA of prostate other than PSA? I was wondering if it is a case of BPH. Thank you