Inclusion Criteria:  PSA level over 4ng/dl Suspicious hard prostatic nodule on digital rectal examination. Hypoechoic lesion on ultrasound of the prostate suspicious for cancer.  Exclusion Criteria:  Less than 20 years old History of surgery on the prostate such as HoLEP More than moderate cognitive impairment which limits understanding of the study Medical conditions precluding transrectal procedures such as rectal cancer