Can't advise you what to do Brian for the best but can only tell you my husband's experience.
He was scheduled for a TRUS following mpMRI but after reading one too many horror stories about the pain during the procedure he politely asked a couple of weeks before the due date if he could be lightly
sedated. They declined this saying this is not how we do it here. ( Local general hospital who just do the tests but not treatment if PCa is found) If they had offered him some diazepam he would have gone ahead with it.
He declined with the result that a registrar rang him back and was sympathetic enough to offer the Template biopsy. With hindsight we are glad this happened because out of 38 samples, 9 were Gleason 3 and only one a 4.
We can't help but wonder if he had gone ahead with the TRUS it is unlikely it would have found the 4 and he may well have been persuaded to go down the active surveillance route leaving the more dangerous 4 element to progress..
As it happens his post prostatectomy histopathology results were good although it did show moderate patchy lesions and at the apex the cancer was only 0.5mm away from breaking through so he may well have missed his window of opportunity for the surgeon to achieve negative margins which are obviously better than positive ones.