You appear to be on the ball and being proactive .
Re: your rising PSA . I assume you have checked that it is not due to a urine infection or BPH .
Have you considered a Liquid Biopsy ( Biomarker Test ) 4K , SelectMDx , Prostate Health Index ( PHI ) or Decipher etc . to compliment your PSA findings ?
Regarding a Transrectal vs Transperineal Biopsy . Some states and European countries only perform the Transperineal for obvious reasons --- Less risk of serious infection ( Sepsis )