To remove a calculus, Civiale inserted his instrument through the urethra and bored holes in the stone. Afterwards, he crushed it with the same instrument and aspired the resulting fragments or let them flow normally with urine. Civiale founded the first urology service in the world, at the Necker Hospital in Paris.
Civiale has been also recently recognized as a pioneer of evidence-based medicine.
In 1835, the Académie des Sciences in Paris commissioned a report on the statistical research that had been conducted by him on a wider scale throughout Europe, with the aim of proving that bladder lithotripsy was superior to lithotomy. Civiale used for the first time the method of comparing the relative mortality rates between both groups of patients, and found that the new lithotripsy method had had 7 deaths in 307 operations (22%), while the old lithotomy method had 1,024 deaths in 5,443 operations (188%).
Among the many students of Civiale, Sir Henry Thompson, a British surgeon and urologist, took the instrument and the technique to Great Britain and became quite famous with it, after operating King Léopold I of Belgium.