A 48-Year-Old Woman Comes to the Clinic Because She Is

A 48-year-old woman comes to the clinic because she is "urinating all the time."  The patient initially had some leakage of urine with sneezing or coughing, but now she leaks while walking to the bathroom.  She voids frequently during the day and several times each night.  The patient sometimes has an intense urge to urinate but passes only a small amount when she tries to void.  She now wears a pad every day and plans her social outings based on bathroom access.  The patient has had no dysuria or hematuria.  She had 2 vaginal deliveries in her 20s.  She drinks alcohol socially, has 2 or 3 cups of coffee each morning, and "drinks lots of water throughout the day."  When asked which urinary symptoms are the most troublesome, the patient is unsure.  Which of the following is the best next step in management of this patient?

A) Cystoscopy
B) Midurethral sling
C) Oral antimuscarinics
D) Urodynamic testing
E) Voiding diary