You sound just like me. No cancer in my family, history of prostatitis, enlarged prostate, sex before my PSA, ran 5 miles the morning of my physical, even had a negative biopsy performed 5 yrs. ago ... I was just looking for reasons not to go through another biopsy. Now I'm very glad I went through with it.
One thing that changed since the last biopsy - my urologist no longer performs biopsies in his office, but rather does them at a surgical center that specializes in minor outpatient procedures. In my case, because I was experiencing urinary obstruction symptoms, he also wanted to do a cystoscopy to get a look at my bladder. So I asked if I could get the kind of anesthesia (MAC*)that's typically given for colonoscopies instead of a local anesthesia like I had the last time. I liked this method much better - woke up after it was all over.
(By the way, no reflection on this urologist, but I found another to do the surgery when I was exploring options after my diagnosis).
For peace of mind for you and your wife, get the biopsy done. I wish you the best of luck and hope you get good news. (Of course, that would also mean you wouldn't be visiting this forum anymore, but that's our loss, not yours).
*Like general anesthesia, MAC uses sedatives and other agents, but the dosage is low enough that patients, remain responsive and breathe without assistance. MAC is often used to supplement local and regional anesthesia, particularly during simple procedures and minor surgery. http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijh/vol1n1/mac.xml