Objective: Concerns exist regarding the risks of mid-urethral slings (MUS) for stress urinary incontinence (SUI), particularly the lack of long-term data. We compare patient reported outcomes of a multicentre randomised controlled trial of retropubic (TVT-GYNECARE) versus transobturator (TOT-MONARC) tape surgery at 12 years. Design and setting: A multicentre study was performed in 11 tertiary referral centres. Population: The 180 participants from the original trial. Methods: Postal questionnaire survey of Patient Reported Outcome Measures using the International Consultation on Incontinence Questionnaire, Patient Global Impression of Improvement questionnaire (PGI-I) and a Numeric rating scale pain questionnaire. Main outcome measures: comparison of the efficacy and complications between the TVT and TOT procedures in the long term. Results: 110/180 responses were received: 55 TVT and 55 TOT participants. Mean follow up: 12.8 years, STD +/- 0.29 years. TVT was significantly superior to TOT in terms of cure ie no SUI: 41.8% TVT versus 21.8% TOT (p=0.04). Urgency urinary incontinence (UUI) was the most bothersome urinary symptom: 14.5% TVT and TOT respondents reported UUI most or all the time. Severe groin/ vaginal pain was reported in 4.8% TVT and 1.7% TOT participants. 80% TVT and 77% TOT participants reported their symptoms as improved on the PGI-I. Conclusions: TVT is superior to TOT for SUI cure. Efficacy and patient satisfaction are reduced by 12 years. Severe vaginal or groin pain is uncommon. Careful patient counselling of long-term outcomes is required. The MUS appears to be an effective treatment for the majority of women with SUI.