If Your Surgery Was Delayed Because of a Fluid Shortage, You're Not Alone

Across the country, hospitals and surgical centers have been scrambling to keep essential irrigation solutions in stock — and Mannitol/Sorbitol irrigation solution is one of the hardest-hit products. If you've been told your transurethral surgery or hysteroscopy has been postponed due to supply issues, you're not imagining things. This shortage is real, it's widespread, and it's been going on since late 2024.

In this post, we'll explain what Mannitol/Sorbitol is, why it's become so difficult to find, and what you and your healthcare team can do about it in 2026.

What Is Mannitol/Sorbitol?

Mannitol/Sorbitol is a sterile, nonelectrolytic irrigation solution used during certain surgical procedures. It contains two sugar alcohols — Sorbitol (2.7%) and Mannitol (0.54%) — dissolved in water for injection. The solution comes in large 3,000 mL bags and is used to flush the surgical area during procedures like:

• Transurethral resection of the prostate (TURP) — one of the most common prostate surgeries
• Other transurethral urologic procedures
• Hysteroscopic surgeries, including endometrial ablation

Because the solution is nonconductive (it doesn't carry an electrical charge), it's safe to use with monopolar electrosurgical instruments — the tools surgeons rely on to cut and cauterize tissue during these procedures. Without a proper irrigation fluid, these surgeries simply can't be performed safely.

To learn more about how this medication works, see our guide on how Mannitol/Sorbitol works.

Why Is Mannitol/Sorbitol So Hard to Find?

There are several reasons this critical surgical supply has been in short supply. Here are the main factors driving the shortage in 2026:

1. Hurricane Helene Devastated a Major Manufacturing Facility

In September 2024, Hurricane Helene caused catastrophic damage to Baxter International's North Cove manufacturing facility in Marion, North Carolina. This single plant produced approximately 60% of the nation's IV fluids and irrigation solutions. When the facility went offline, it triggered the most severe sterile fluid shortage in recent U.S. history.

While Baxter primarily manufactured other IV solutions at that facility, the sudden gap in supply created a domino effect. Hospitals that couldn't get their usual Baxter products turned to alternative manufacturers like ICU Medical — the sole U.S. manufacturer of the Mannitol/Sorbitol combination product — overwhelming their production capacity.

2. ICU Medical Is the Only Manufacturer

Unlike many medications that have multiple generic manufacturers, ICU Medical (through Otsuka ICU Medical LLC) is the only company producing Sorbitol-Mannitol irrigation solution in the United States. When you have a single source for a critical product and demand suddenly spikes, shortages are almost inevitable.

ICU Medical placed the product on allocation, meaning hospitals could only order limited quantities based on their historical purchasing patterns.

3. Ongoing Supply Chain Challenges

Even before Hurricane Helene, the sterile fluid market was fragile. The irrigation solution supply chain has experienced periodic shortages since at least 2018, driven by limited manufacturing capacity, aging facilities, and the high cost of maintaining sterile production environments. The hurricane simply exposed how vulnerable the system already was.

4. Recovery Has Been Slower Than Expected

Baxter restarted production lines in late 2024 and announced a recovery timeline, but full production didn't resume until well into 2025. Even with Baxter back online, the ripple effects continue. ASHP (the American Society of Health-System Pharmacists) still lists multiple irrigation solutions on their current shortage list as of early 2026.

For the latest shortage updates, check our Mannitol/Sorbitol shortage update for 2026.

What Can You Do If Your Surgery Is Affected?

If you're a patient waiting for a procedure that requires Mannitol/Sorbitol irrigation, here are some steps you can take:

Talk to Your Surgeon About Alternatives

There are other irrigation solutions that may work for your procedure. Glycine 1.5% is the most common alternative for TURP and similar surgeries, though it carries a slightly higher risk of certain neurological side effects. Normal saline can be used if your surgeon has access to bipolar surgical instruments. Your surgical team can help determine the best option for your specific situation.

Learn more in our post on alternatives to Mannitol/Sorbitol.

Ask About Facility Inventory

Not all hospitals and surgery centers are equally affected. Larger hospital systems may have better allocation agreements or stockpiles. If your procedure is being delayed at one facility, it may be worth asking your surgeon if another location has supply available.

Use Medfinder to Check Availability

You can use Medfinder to check which facilities near you have Mannitol/Sorbitol in stock. Our tool helps connect patients with pharmacies and facilities that currently have supply, so you're not making blind phone calls.

For more tips, read our guide on how to find Mannitol/Sorbitol in stock near you.

Don't Delay Urgent Procedures

If your surgery is medically urgent — for example, if you're experiencing urinary retention or significant bleeding — make sure your healthcare team knows. Urgent cases are typically prioritized when supplies are limited, and your surgeon may be able to use an alternative irrigation solution to proceed without delay.

Final Thoughts

The Mannitol/Sorbitol shortage is a frustrating reality for patients and healthcare providers alike. It's the result of a fragile supply chain, a natural disaster, and the fact that a single manufacturer controls the entire U.S. supply of this product. While conditions have improved since the worst of the crisis in late 2024, allocation limits and spot shortages continue into 2026.

The good news is that alternatives exist, and your surgical team has experience navigating these challenges. If you're facing a delayed procedure, stay in communication with your provider, explore your options, and use tools like Medfinder to stay informed about availability in your area.

For more information about this medication, visit our complete guide: What is Mannitol/Sorbitol?