
Possibility Of Damage To Nerve Bundle, Incontinence, Infection, PSA Test, Biopsy. Suggestion?

Based on my clinical experience you have all the reasons - raised total and free PSA with family history, to be subjected to prostate biopsy. It is absolutely indicated to rule out the possibility of prostrate tumour
I agree with you that better markers are not available at this point of time, but I do not suggest you to wait till then. I think you need to go ahead with the procedure if you haven't got it done yet. Though this is not something that is needed immediately, you would need to consider it at the earliest.
Complications do exist with prostate biopsy, but probably they are overstated by your. When performed by an experienced and competent doctor, the procedure is successful without any major complications.
Few other tests such as ultrasound abdomen and pelvis, CT scan might help in the diagnosis; however they are less conclusive diagnostically when compared to biopsy and pathological studies. I encourage you to go ahead with the biopsy without a second thought.
Hope this helps.
Regards

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