Dear Dr Handsfield, I know the Forum Guidelines and I don't want to violate them. Please accept my sincere apologies for contacting you again. Unfortunately I have not had any luck with my therapy to treat my obvious OCD. In this respect I can understand if you admonish me. 

But: just a quick question first: In the last post you mentioned "as long as the head of the penis is covered" - I read that in many places here, but isn't the inner side of the foreskin also at risk of infection? Back to HPV I would like to add something else:

About 18 years ago, there was also a protected intercourse. If I got HPV back then and infected my wife, it should be cleared by now, right? All of her Pap-smears afterwards have been fine. 

What we haven't discussed so far is the oral HPV risk, i.e. the risk of getting HPV in the mouth and possibly passing it on.

My wife (43 years old) will probably have her next gyn appointment in 2022 (here in Germany). She will get a Pap smear and possibly also an HPV test, in 2025 she will have both. This is because of the regulations on preventive medical check-ups here in Germany. 

I am afraid this will haunt me for the rest of my life. And I am so annoyed that I was not aware of the risks at the time, but now this knowledge has become a big burden. As stupid as it sounds...

I know I can't do anything, but can i move on? Is the overall risk too small to worry day and night? I mean, if something like this can lie dormant for decades..

A condom that covers the head of the penis probably always or nearly always also covers the inner surface of the foreskin.

Once HPV is acquired, HPV DNA often (always?) persists for life, with potential for reactivation. As discussed for the recent exposure, the odds are low that you were infected during a single episode of condom protected sex. If HPV ever shows up in you or your wife, there is no reason to suspect the recent sexual exposure versus the previous one. 

Oral HPV isn't rare, but it's a lot less common than genital. The risk of acquiring oral HPV during any single oral sex exposure probably is well under 1 in many thousand.

Probably your wife's HPV test and pap smear will be negative. If positive, almost certainly it would not be from your recent extra-marital sexual event.

"can i move on?" Yes, you can and should. However, it seems unlikely you will be able to do so until and unless you get professional counseling. "I am afraid this will haunt me for the rest of my life" shows a level of concern that is not normal, especially after the harmless nature of most HPV infections and the repeated science-based reassurance you have had on this forum, and perhaps from your own doctors.  See my comments in your previous threads about professional counseling. Please take it seriousliy.

A last bit of advice. Next time you're among a group of people (safely, preventing COVID-19) -- co-workers, friends, anyone you know -- scan the group and remind yourself that almost all of them have had genital HPV and for those age 20-50, rroughly half have active, detectable infections at this time. So what if you're among them? Having HPV is a normal, expected, unavoidable consequence of having sex -- that is, in almost all humans. 

HHH, MD

thank you for the encouraging words. Regarding HPV, it‘s not important if it comes from a long time ago CSW exposure or a newer one. I’m more concerned about a general risk of protected sexual intercourses and the one case of unprotected fellatio. 

"Probably your wife's HPV test and pap smear will be negative. If positive, almost certainly it would not be from your recent extra-marital sexual event", this reassures me, but the fact that we both (44 and 43) in 26 years of relationship (lifelong monogamous) had no other sex partners (except for the events that I’ve described) makes me very afraid of a possible positive result. Whether normal and mostly harmless or not. Because I‘m guilty anyway. 

That is why the "Move on" is so difficult for me. Not knowing if it will ever happen and if so when...that’s because i think it will haunt me forever. That others had or have it is a small consolation, because most of them had other partners in the past.

Regarding herpes: I‘ve had neither oral nor genital symptoms. I wanted to do a test recently, but my lab obviously has no test that can differentiate between HSV1 and 2, although they actually offer IgG and IgM on their homepage. So it’s probably only an IgM. That wouldn’t help me at all. On one post  you once said that someone should not get tested after single events without symptoms anyway. But isn't that a risk with the possible asymptomatic courses of Herpes?

Anyway: I had already started a therapy, but unfortunately I had gotten the wrong therapist and now I have to find a replacement :-(

But one more question, why do you say "If positive, almost certainly it would not be from your recent extra-marital sexual event"? 

And: Is my HPV risk and the possibility that it will ever occur in any form too low to worry about?

I.e. are the normal intervals of examinations for my wife sufficient?

" Is my HPV risk and the possibility that it will ever occur in any form too low to worry about?"  Of course. That's the whole point of almost everything you have been advised in this and your previous threads on this forum. I haven't changed my mind!

Your wife should follow standard recommendations in Germany for pap smear frequency and/or HPV testing. Those guidelies are entirely independent of women's partners' HPV/STD risks. (My reply, and this advice, would be the same if you told me you had been with 50 commercial sex partners, unprotected, in the last 10 years.)

That concludes this thread. Please note my opening comment:  any further questions along these lines will be deleted without reply and without refund of the posting fee. If you remain concerned, re-read your previous threads. ASHA does not wish to collect fees from anxious persons who can expect to hear the same answers yet again. In addition, repeat questions have low educational value for other users, one of the main goals of the forum. Thank you for your understanding. I hope this final discussion is helping you move on without worry.