I had a transrectal biopsy, where the samples are taken inside. There's a higher risk of infection but they give you a dose of antibiotics before hand to try and lessen that risk.
It really wasn't painful and only mildly embarrassing, but its a medical procedure after all.
The transperineal version still has an ultra sound probe inside but the needles go in from outside.
Whichever you have you will still get blood in your pee and semen, which can look quite scary till it clears, but you already know that.
They didn't do any form of DRE on me before the MRI scan as they said it was pretty unreliable and more or less redundant as a diagnostic tool.
I hope you get a biopsy, you do have to push and advocate for these things. I think there is a reluctance to carry out procedures that on paper seem unnecessary but that to the worried patient would mean a lot of reassurance. My brother was denied an MRI in the early stages as they said it wouldn't add to what they knew. 5 months later he is waiting fir an MRI as something is going on they didn't expect. Woukd it have been better to have done an MRI back when they really should have? I think so, but they would never admit to that.
The NHS are good, but they are under pressure from government etc to keep costs down, so you do have to know what you want and press for it.
My own GP has set up psa testing for me every six months, despite the hospital saying it should only be repeated if I had any further concerns about my prostate. The thing is I didn't have any symptoms or concerns until the random psa test. I really got the impression I was thought of as being a time waster by the MDT as they were very dismissive when my results were clear.
Let us know how things pan out.
Mick