Prostate biopsy is the recommended diagnostic test for prostate cancer in patients with abnormal findings during digital rectal examination (DRE) or elevated prostate-specific antigen (PSA) levels.1 Although transperineal prostate biopsy is increasing, standard transrectal ultrasound-guided prostate biopsy (TRUS-PBx) shows similar prostate cancer detection rates.2 When the procedure is explained, patients with no prior experience are particularly susceptible to anxiety.3 Moreover, increased anxiety during the procedure is associated with higher pain perception and irritation. This evidence concerns the gene KLK3 and prostate cancer.