I would go with B
This pt has incontinence AFTER voiding, a fact which excludes overflow incontinence which is classically seen in BPH. Also, the patient experiences the need to void (watch out! no incontinence!) during the night, which points to an overreactive bladder! Overflow incontinence due to BPH is associated with bedwetting, not the nightly urge to void!
Even if we did a rectal examination first, it is not uncommon for 68yo people to have a comorbid BPH as in this patient whilst having a UTI. Thus, we would comfort ourselves that this pt has BPH and miss the UTI...
Dysuria, even though common it is not always present in UTIs.