You can use the MDriven Framework to do the evolve-database operation from within VisualStudio:

You can also do these operations at runtime:

PersistenceMapperAdo2 pmapp        
var systemservice = YourEcoSpace.GetTypeSystemService();        
string[] ExecutedStatements;        
string result;          
IDBEvolutor evolutor = pmapp.GetEvolutor(systemservice);          
evolutor.CalculateScript();          
evolutor.GenerateDbScript();          
evolutor.GenerateMappingScript();          
evolutor.GenerateWarnings();          
evolutor.GenerateErrors();          
evolutor.ExecuteScript();          
result = "Evolve success\r\n";          
ExecutedStatements = evolutor.GenerateExecutedStatements();        
foreach (string s in ExecutedStatements)          
  result += s + "\r\n"; 

To fill a database with schema information for the first time:

PersistenceMapperAdo2 pmapp
pmapp.CreateDatabaseSchema(YourEcoSpace.GetTypeSystemService(), new DefaultCleanPsConfig(true));