BackgroundThe aim of this study was to investigate the add-on effect of postural instructions to an abdominopelvic exercise program on urinary symptoms and QoL in perimenopausal, menopausal and postmenopausal women with stress urinary incontinence (SUI).MethodsA randomized controlled trial was performed with a total of 40 perimenopausal, menopausal and postmenopausal women with SUI aged between 46 and 75 years old. Participants were randomly assigned to two groups: a group performing an abdominopelvic exercise program (AEP) (n = 20) and a group performing abdominopelvic exercise with the addition of postural instructions (AEPPI) (n = 20). Primary outcome measures were UI symptoms, UI impact and QoL, measured by 48 h Pad Test and ICIQ-UI-SF, which were assessed at baseline, post-intervention and 3 months follow-up. Secondary outcome was patient’s satisfaction measured by VAS scale only after the intervention.ResultsBetween-groups differences were observed in terms of ICIQ-UI-SF scores inmediately after intervention. Within-groups differences were observed between baseline to 3 months follow-up and between post-intervention to 3 months follow-up in AEPPI group (p < 0.05) for ICIQ-UI-SF and UI impact. UI symptoms were improved in both groups between baseline to 3-months follow-up (p < 0.05). Patient’s satisfaction was higher in AEPPI group (p < 0.05).ConclusionThe addition of postural instructions to an abdominopelvic exercise program improves QoL and patients’ satisfaction in women with SUI.Trial registrationThis study was retrospectively registered at ClinicalTrials.gov under the number NCT03727945, https://clinicaltrials.gov/ct2/show/NCT03727945