The primary cause of a positive test for Hgb (hemoglobin) is because of blood in the urine. However, the microscopic examination, though, is the test that will be able to say with certainty whether there is blood in the urine.
The urine test for hemoglobin can also be positive if there is myoglobin in the urine. If the microscopic examination does not show any red blood cells in the urine, then the positive Hgb test is typically due to myoglobin. Myoglobin is a similar protein to hemoglobin, but is present in muscles. If there is any muscle problem, then it can cause this pattern of result.
If the microscopic examination shows red blood cells, then this is a continuation of the chronic problem that you have been having with blood in the urine. It is good that you have had a cystoscopy, but a complete evaluation would typically also include evaluation of the upper urinary tract, such as with a CT scan.
The trace ketones is not an issue, and usually indicates that you should be drinking more fluids.
Have you had a CT scan done of the upper urinary tract?