Not to seem blunt but you realize she didn't come here to figure out how to make her husband happy. She is feeling that he's being insensitive to her needs while she has tried to maintain a sex life and seek solution to her current medical issue which is making sex painful for her. We always see men claim that they would be ok if their wife had a medical issue and was seeking treatment. Well she has a medical issue, she's seeking treatment and trying to maintain a sex life while lots of times it is painful or creates pain. So after a long marriage he's actually implying it's a divorcable offense if he can't ejaculate inside her. Doing this in response to her calling for support because she's literally in pain walking around the grocery store (shopping for him groceries).
So she probably isn't worried right this minute if he's ok with a BJ. And it isn't a different entry for PIV sex that isn't PIV sex.