Hi, I was in a similar position to you a few months ago. MRI scan showed two areas of concern that they wanted to biopsy. I was given a choice I guess but it was more or less a case of it needs checking out so we are booking you in.
My biopsy was transrectal which means everything is done with a probe and little sampling head popped up the back passage. I had it done without a general anaesthetic as its quicker to get out of hospital. Honestly, it was very easy, yep a bit of embarrassment but it was nothing near as bad as I'd built myself up for.
They gave me strong antibiotics before the op to deal with any potential infection and I had no issues at all.
Yes there is blood in your pee for a couple of days and blood in your semen for a lot longer because you dont flush it out as quickly as peeing all the time. It looks scary having rusty coloured come, but it really is nothing and it will go away.
There is a method called transperineal which has needles inserted from outside the body. But you still have the sane sized ultrasound probe up your bottom to guide the needles. So you dont escape that part of the procedure.
I would definitely have the biopsy done, Mine came back negative so it put my mind at rest pretty much. The only fly in my ointment was that they only took three samples from each area and none at all from apparently healthy tissue. That's the NICE guidelines. But many guys on here say the suspicious areas were clear and seemingly healthy areas came back positive. Im pushing for another biopsy on the 12 month anniversary to check healthy areas as there is some doubt in my mind, plus my older brother has just been diagnosed with stage 4 metastatic PCa which is terminal.
Get them to do as many samples as they can while they are up there, just to be sure.
Best regards Mick