AIM: The purpose of this study was to compare the effect of Kegel exercises plus abdominal exercises to Kegel only exercises on urinary incontinence severity, quality of life, and sleep quality in postmenopausal women with stress urinary incontinence (SUI). METHODS: This prospective, randomized controlled trial adhered to the CONSORT guidelines and included 70 postmenopausal women (35 in each group) diagnosed with SUI who attended an Obstetrics and Gynecology outpatient clinic in northern Turkey between May and November 2023. The experimental group performed Kegel and abdominal exercises, while the control group practiced Kegel exercises only. Both groups followed a 12-week exercise program, with data collected through pre- and post-tests and three face-to-face interviews during the intervention period. RESULTS: After the 12-week exercise programs, both Kegel only and Kegel plus abdominal exercise combination decreased the severity of incontinence and improved quality of life and sleep quality in postmenopausal women with SUI (p <
0.001). However, in this population, Kegel plus abdominal exercises give better results than Kegel only exercises (p <
0.001). CONCLUSIONS: According to the outcome of this evidence-based study, it is recommended that exercise programs combining Kegel and abdominal exercises be established for postmenopausal women with SUI within the scope of conservative treatment.