Inclusion Criteria:  Men undergoing a first-time prostate biopsy to rule out cancer Serum PSA ≥3ng/mL, ≤20ng/mL Age≥50 years, ≤80 years Clinical stage ≤T2c Patients must be able to provide written informed consent.  Exclusion Criteria:  Patients has any prior needle biopsy of the prostate Patients has a prior history of prostate cancer Patients has a prior history of pelvic radiation therapy or androgen deprivation therapy Patients has a prior history of BPH operation Patient with uncorrectable coagulopathies Unable to tolerate a TRUS guided biopsy. Patients had 5-alpha reductase inhibitor in the past six months. The patient has had a urinary tract infection or acute prostatitis in the last three months.