to thig350, the guided biopsy is done in the hospital due to the equipment necessary for the procedure. Guided is only done when you have a MRI to direct the biopsy. If there is no cancer to explain your high PSA, then your urologist will want to put you on active surveillance which usually is biopsies every 8-12 months. I did my first non guided biopsy awake in my Dr's office and would never do that again. It's like going back to the middle ages. After I told him I would not do that again, he offered to have it done back in the hospital where they would put me under. If I didn't decide on a procedure, that is the only way I would have it again. Sometime active surveillance seems worse that radiation or surgery. Good luck.