Rusty trombone is a euphemism for a sexual act in which a man stands while the other partner kneels behind him and performs analingus while reaching up beneath the testicles or around the body to masturbate him, mimicking the motions of a trombone player. The act is defined primarily by the physical orientation of the partners and the combination of analingus with manual penile stimulation; however, other positions and variations are possible. (And encouraged!)
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