There are a few different issues in this question.
First, what is the effect of using and independent test when 2 samples are not independent (paired).
When 2 summary statistics (mean, median, pseudomedian, etc.) are independent, then the variance of their difference is just the sum of the 2 variances, $Var(A-B) = Var(A) + Var(B)$. This is simplest to show with normally distributed means, but this holds for other summaries as well. When the 2 summaries are not independent, then we need a measure of the covariance as well, $Var(A-B) = Var(A) + Var(B) - Cov(A,B)$. If the covariance is positive (the most common case in paired designs), then using the independent test will just use too large of an estimated variance (usually through the standard error in the actual test). This is where the statements about being conservative or lowering the type I error come from (note that it also lowers the power of tests and the precision of confidence intervals, so it may be a bad thing). I see this most often when someone does pre and post surveys on the same sample of subjects, but they did not include anything in the survey to pair the answers, so we do the independent test/interval with the note that it will be conservative if the covariance is positive.
But one important thing that is often skipped over (because it is rare), is that if the covariance is negative, then things swap and the variance/standard error of the independent test/interval is now too small instead of too big, which will increase the risk of type I error and lower the true confidence level of intervals.
The second issue is how to do the MWUt while accounting for pairing, when you are not happy with the sign test or signed rank test. Here I would suggest doing your own permutation test.
The MWUt is already a special case of permutation testing. The original tables were created by looking at all the possible permutations of ranks for given (small) sample sizes where all the permutations were based on independent (non-paired) sampling. You can instead create your own table/critical value/p-value by instead permuting pairs. For a small number of pairs you can create all $2^\text{(n pairs)}$ permutations, calculate the MWU statistic for each permutation, then seeing where the MWU statistic for your original data falls in this null distribution. If that is too many permutations then you can instead randomly permute within pairs, compute the MWU statistic, then repeat a bunch of times to generate the null distribution. I expect that the result will be pretty similar to the signed rank test results.