There have been a couple (at least) of topics on biopsy pain the past 6 months, so you might want to see if you can find them. My recollection is that most guys suffer through the biopsy without too much pain, even if sedative free. However, there were several guys who found the pain very real and very uncomfortable. For me, I had my biopsy under IV anesthesia and it was definitely a piece of cake...one vicodin afterwards and that was it. My uro-doc recommends the anesthesia for two reasons: (a) he sees no reason for his patients to suffer needlessly and (b) he likes to take his time doing the biopsy without a wincing patients begging for it to be over. Your call....
It is difficult to give you much additional advice until we see your biopsy results. There are multiple treatment options...including active surveillance...depending on your stats. Come back and let us know and you will gets lots of advice. In the meantime, of course, there are a multitude of threads that you can read thru here if you want to get some background.
Good luck...hope all is clear and we never hear from you again!!!