I am an 80-year-old man, and nearly 20 years ago I had prostate cancer, which was treated successfully. After surgery, I had some urinary leakage and a bladder sling was implanted, largely solving that problem. I am otherwise in good health. Some years back, my much younger wife wanted a divorce, so now I find myself single. I would like a sexual relationship. I understand that losing some sexual vigour is to be expected at my age, but my problem is that I have urinary leakage when I ejaculate. Aside from partly effective precautions (drinking minimal fluids in advance and urinating before things get serious), what can be done? I don’t know how offensive this is or would be to a partner, nor am I certain how to approach the topic in conversation. It sounds more like a communication issue than a sexual one, but I feel like a repulsive partner. A doctor may be able help you with the medical management side, but there are ways to manage it socially. Try to consider ejaculation as a secondary part of lovemaking, not the main event. Many people race towards orgasm and fail to take the time to truly enjoy eroticism. Most women receive far more pleasure from foreplay – ie sensual touching and clitoral stimulation of various kinds – so maybe you need to brush up on your skills. To truly please a partner you do not need to ejaculate in, on or even near them. Let go of your established pattern and focus not on climaxing but on being responsive to your partner’s needs. Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders. If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions. Comments on this piece are premoderated to ensure discussion remains on topics raised by the writer. Please be aware there may be a short delay in comments appearing on the site.