Prostate Biopsy: What to expect?

A buddy of mine has a prostate biopsy scheduled for the day after tomorrow. His PSA hit 4.7, up from 3.6 last year, so he asked if I knew anyone who’s been through this.
Mainly, I'm trying to figure out how painful this actually is. Is there any real point in pushing for general anesthesia, or is local numbing gel enough to get by?
Any insight would be appreciated.

I haven’t gone through it myself, but I’ve stood by and watched a TRUS biopsy being done... and honestly? It isn't exactly a pleasant experience to witness. Not painful, though. Just... unpleasant.

You’ve got a pretty decent response on this thread...