The history of endourology in Canada

  • Darren Beiko
  • R. John D'A. Honey University of Toronto
  • Kenneth T. Pace University of Toronto
  • John D. Denstedt Western University
  • Hassan Razvi Western University
  • Denis H. Hosking University of Manitoba
  • Richard W. Norman
  • James W.L. Wilson Queen's University
Keywords: history, endourology, shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy


Introduction: Following the introduction of shock wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL), the subspecialty of endourology was born in the late 1970s. The purpose of this study was to report milestones in Canadian endourology, highlighting Canada’s contributions to the field.

Methods: A review of the literature was performed from the late 1970s to the present. The literature review included bibliographic and digital resources. Additionally, records and recollections by various individuals were used, including some who were directly involved.

Results: Endourology was born in Canada when SWL, URS, and PCNL emerged as minimally invasive treatment options for stones in the early to mid-1980s. According to our research, the first PCNL was performed at the University of Toronto in 1981. Dr. Joachim Burhenne, a Harvard-trained radiologist from Germany, first used extracorporeal SWL in Canada at the University of British Columbia (UBC) for the treatment of biliary stones. Treatment for urinary tract stones followed at UBC and Dalhousie University. The first worldwide use of the holmium laser for lithotripsy of urinary tract calculi took place at the University of Western Ontario. Other endourology milestones in Canada include the formation of the Canadian Endourology Group and the emergence of the Endourological Society-accredited fellowship programs at the University of Toronto and Western University in the 1990s. Canada hosted the 21st and 35th World Congress of Endourology and Shock Wave Lithotripsy annual meeting in Montreal and Vancouver, respectively.

Conclusions: Canadian urologists have led many advances in SWL, URS, and PCNL over the past four decades and, for a relatively small community, have made significant contributions to the field. Through the training of the next generation of endourologists at Canadian institutions, the future of endourology in Canada is bright.

Author Biography

Darren Beiko

Associate Professor, Department of Urology, Queen's University


Patel SR, Nakada SY. The modern history and evolution of percutaneous nephrolithotomy. J Endourol 2015;29:153-7.

Smith AD, Lange PH, Fraley EE. Applications of percutaneous nephrostomy. New challenges and opportunities in endo-urology. J Urol 1979;121:382.

Palmer BW, Norman RW. Retroperitoneal air, extracorporeal shock wave lithotripsy and epidural anesthesia. J Urol 1989;141:844-5.

Hosking DH, Ramsey EW. Rigid transurethral ureteroscopy. Br J Urol 1986;58:621-4.

Graham RT, Herschorn S. CT demonstration of irrigant extravasation following percutaneous nephrolithotomy. Can Assoc Radiol J 1988;39:284-5.

Becker CD, Fache JS, Gibney RG, Scudamore CH, Burhenne HJ. Choledocholithiasis: treatment with extracorporeal shock wave lithotripsy. Radiol 1987;165:407-8.

Pace KT, Tariq N, Dyer SJ, Weir MJ, D'A Honey RJ. Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol 2001;166:2065-71.

Weir MJ, Tariq N, Honey RJ. Shockwave frequency affects fragmentation in a kidney stone model. J Endourol 2000;14:547-50.

Pace KT, Ghiculete D, Harju M, Honey RJ; University of Toronto Lithotripsy Associates. Shock wave lithotripsy at 60 or 120 shocks per minute: a randomized, double-blind trial. J Urol 2005;174:595-9.

Hosking DH, Bard RJ. Ureteroscopy with intravenous sedation for treatment of distal ureteral calculi: a safe and effective alternative to shock wave lithotripsy. J Urol 1996;156:899-901.

Denstedt JD, Razvi HA, Sales JL, Eberwein PM. Preliminary experience with holmium: YAG laser lithotripsy. J Endourol 1995;9:255-8.

Denstedt JD, Wollin TA, Sofer M, Nott L, Weir M, D'A Honey RJ. A prospective randomized controlled trial comparing nonstented versus stented ureteroscopic lithotripsy. J Urol 2001;165:1419-22.

Dagnone AJ, Blew BD, Pace KT, Honey RJ. Semirigid ureteroscopy of the proximal ureter can be aided by external lower-abdominal pressure. J Endourol 2005;19:342-7.

Hosking DH. Retrograde nephrostomy: experience with 2 techniques. J Urol 1986;135:1146-9.

Finelli A, Honey RJ. Thoracoscopy-assisted high intercostal percutaneous renal access. J Endourol 2001;15:581-4.

Denstedt JD, Eberwein PM, Singh RR. The Swiss Lithoclast: a new device for intracorporeal lithotripsy. J Urol 1992;148:1088-90.

Ray AA, Chung DG, Honey RJ. Percutaneous nephrolithotomy in the prone and prone-flexed positions: anatomic considerations. J Endourol 2009;23:1607-14.

Shahrour W, Andonian S. Ambulatory percutaneous nephrolithotomy: initial series. Urology 2010;76:1288-92.

Beiko D, Lee L. Outpatient tubeless percutaneous nephrolithotomy: the initial case series. Can Urol Assoc J 2010;4:E86-90.

Preminger GM, Clayman RV, Curry T, Redman HC, Peters PC. Outpatient percutaneous nephrostolithotomy. J Urol 1986;136:355-7.

Beiko D, Elkoushy MA, Kokorovic A, et al. Ambulatory Percutaneous Nephrolithotomy: What Is the Rate of Readmission? J Endourol 2015;29:410-4.

[No authors listed] Recognized Fellowship Programs in Endourology. J Endourol 2004;18:799-802.

[No authors listed] Recognized fellowship programs in endourology. J Endourol 1996;10:307-8.

How to Cite
Beiko, D., Honey, R. J. D., Pace, K. T., Denstedt, J. D., Razvi, H., Hosking, D. H., Norman, R. W., & Wilson, J. W. (2019). The history of endourology in Canada. Canadian Urological Association Journal, 14(2), 12-6.