I had HIFU treatment (Sonoblate 500) in Mexico in June of 2007 (51 years old, PSA 6.0, Gleason 3+3). I missed one day of work traveling back from Mexico on a Monday, had the the catheter removed after 17 days, and was able to have sex the next day. ISounds easy but this period of time was very uncomfortable and I worked from home the second week while I was trying to flush out my bladder and work on learning to urinate on my own again.
I sleep through the night without getting up to urninate. For about 8 months it seemed that when I had to urinate, the urge was stronger. Now I don't even notice it. My quarterly PSA tests have been: 1.1, 0.8, and 0.5. There were two other men treated the same day as me and their results are very similar. Both men were 50 to 60 years old and they have not reported any complications. I've talked 17 men who have had HIFU and only one of them seemed to have permanent ED problems and more issues with his urinary tract being blocked (his followup PSA was 0.02 and he had an aggressive treatment). Several men had problems with the catheter (blockage or urinary tract infection) which were temporary, several use cialis to assist in getting erections, and two reported very minor incontinance issues that they felt were not very inconvenient. Although my information is very unscientific, every person I talked to recommended HIFU and would do it again if they had to make the choice again. I would also recommend it if you are a candidate (early stage cancer that is within the prostate. As for follow up care, your urologist should support you in whatever treatment you choose. Check it out ahead of time and find a new one if you cannot get support. Even though my urologist is completely against HIFU, he said I was his patient and his job was to support me. Funny thing was, he then told me he had a personal friend in the medical field that was flying to Germany for HIFU treatment and he had tried to discourage him as well...