My urologist is in a solo practice and is super busy; his office does not have any PAs. We live in a small city of about 40,000 people, so smaller than where you are. When I have a cystoscopy check-up, or when I've had the two TURBTs, I try to ask him any questions I have. At first, my husband came with me, so there were two of us to ask questions and two of us to hear the answers. It's all gotten so routine for me now that my husband no longer comes along, though he does offer to do so. The suggestion of writing things down ahead of time is a good one, though something may always come up in the visit that you hadn't anticipated, and you may have addiitonal questions as a result.
My BCG treatments are done by a great nurse, but she will call in the urologist if she has any problems. She can only do the BCG treatments when the urologist is in the office. I think the urologist did it himself just a few times, once when the nurse was out sick and a couple of times when she had trouble getting the catheter in (due to my anatomy, not her lack of skill). The office used to only have the one nurse (female) but I see they now seem to have a guy as well (possibly he's a PA, but I've never had him).
So long as the urologist is available in the office and will answer questions the PA can't, I wouldn't rule out seeing the PA.
Ann